How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,000 to $251,189Professionalmedian $9,333 · 10th to 90th $2,818 to $15,136
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $9,772.37 Median $14,125.38 Typical High $16,595.87 | Facility | None | $9,772.37 | $14,125.38 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $15,135.61 Typical High $15,135.61 | Professional | None | $2,754.23 | $15,135.61 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,981.07 Typical High $8,709.64 | Professional | None | $2,570.40 | $3,981.07 | $8,709.64 |
Moda Health Setting Facility Modifier None Typical Low $4,570.88 Median $15,135.61 Typical High $21,877.62 | Facility | None | $4,570.88 | $15,135.61 | $21,877.62 |
Moda Health Setting Professional Modifier None Typical Low $3,090.30 Median $11,748.98 Typical High $16,982.44 | Professional | None | $3,090.30 | $11,748.98 | $16,982.44 |
Premera BCBS Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Professional | None | $11,748.98 | $11,748.98 | $11,748.98 |
Providence Setting Facility Modifier None Typical Low $15,488.17 Median $251,188.64 Typical High $346,736.85 | Facility | None | $15,488.17 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $4,073.80 Typical High $8,709.64 | Professional | None | $60.26 | $4,073.80 | $8,709.64 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $4,265.80 | Facility | None | $691.83 | $1,071.52 | $4,265.80 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $7,413.10 Typical High $16,982.44 | Professional | None | $2,511.89 | $7,413.10 | $16,982.44 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,380.38 Median $7,585.78 Typical High $7,585.78 | Professional | 52 · Reduced service | $1,380.38 | $7,585.78 | $7,585.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $3,019.95 Typical High $3,019.95 | Professional | 53 · Discontinued | $549.54 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $11,481.54 Typical High $11,481.54 | Professional | 54 · Surgery only | $2,089.30 | $11,481.54 | $11,481.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $2,290.87 Typical High $2,290.87 | Professional | 55 · Aftercare only | $416.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $1,513.56 Typical High $1,513.56 | Professional | 56 · Pre-op care only | $275.42 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $10,715.19 Typical High $10,715.19 | Professional | 78 · Unplanned return to OR | $1,949.84 | $10,715.19 | $10,715.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $7,585.78 Typical High $7,585.78 | Professional | 52 · Reduced service | $1,548.82 | $7,585.78 | $7,585.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $3,019.95 Typical High $3,019.95 | Professional | 53 · Discontinued | $630.96 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $11,481.54 Typical High $11,481.54 | Professional | 54 · Surgery only | $2,344.23 | $11,481.54 | $11,481.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $2,290.87 Typical High $2,290.87 | Professional | 55 · Aftercare only | $467.74 | $2,290.87 | $2,290.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $1,513.56 Typical High $1,513.56 | Professional | 56 · Pre-op care only | $309.03 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $10,715.19 Typical High $10,715.19 | Professional | 78 · Unplanned return to OR | $2,187.76 | $10,715.19 | $10,715.19 |
Where Alaska sits
The same service costs 21.4 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Alaska· 1st of 51
$9,772
AK $9,772TX $457
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.