How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,000 to $251,189Professionalmedian $4,898 · 10th to 90th $1,445 to $7,586
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 $7,585.78 Median $12,022.64 Typical High $16,595.87 | Facility | None | $7,585.78 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $7,585.78 Typical High $7,585.78 | Professional | None | $1,445.44 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $4,265.80 | Professional | None | $1,230.27 | $1,995.26 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $2,344.23 Median $7,585.78 Typical High $10,964.78 | Facility | None | $2,344.23 | $7,585.78 | $10,964.78 |
Moda Health Setting Professional Modifier None Typical Low $1,548.82 Median $6,025.60 Typical High $8,912.51 | Professional | None | $1,548.82 | $6,025.60 | $8,912.51 |
Premera BCBS Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Providence Setting Facility Modifier None Typical Low $7,943.28 Median $251,188.64 Typical High $346,736.85 | Facility | None | $7,943.28 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $2,041.74 Typical High $4,265.80 | Professional | None | $60.26 | $2,041.74 | $4,265.80 |
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 $1,348.96 Median $3,890.45 Typical High $8,912.51 | Professional | None | $1,348.96 | $3,890.45 | $8,912.51 |
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 $724.44 Median $3,801.89 Typical High $3,801.89 | Professional | 52 · Reduced service | $724.44 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $1,513.56 Typical High $1,513.56 | Professional | 53 · Discontinued | $288.40 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $5,754.40 Typical High $5,754.40 | Professional | 54 · Surgery only | $1,071.52 | $5,754.40 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $1,148.15 Typical High $1,148.15 | Professional | 55 · Aftercare only | $213.80 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $758.58 Typical High $758.58 | Professional | 56 · Pre-op care only | $144.54 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $5,370.32 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $1,000.00 | $5,370.32 | $5,370.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $3,801.89 Typical High $3,801.89 | Professional | 52 · Reduced service | $776.25 | $3,801.89 | $3,801.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $1,513.56 Typical High $1,513.56 | Professional | 53 · Discontinued | $309.03 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $5,754.40 Typical High $5,754.40 | Professional | 54 · Surgery only | $1,174.90 | $5,754.40 | $5,754.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $1,148.15 Typical High $1,148.15 | Professional | 55 · Aftercare only | $234.42 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $758.58 Typical High $758.58 | Professional | 56 · Pre-op care only | $154.88 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $5,370.32 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $1,096.48 | $5,370.32 | $5,370.32 |
Where Alaska sits
The same service costs 5.0 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
$5,012
AK $5,012TX $1,000
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.