How much rates vary
Facilitymedian $7,586 · 10th to 90th $3,981 to $23,988Professionalmedian $2,692 · 10th to 90th $759 to $3,981
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 $2,344.23 Median $10,000.00 Typical High $20,417.38 | Facility | None | $2,344.23 | $10,000.00 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $3,981.07 Typical High $3,981.07 | Professional | None | $741.31 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $23,988.33 | Facility | None | $4,677.35 | $7,762.47 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $2,290.87 | Professional | None | $691.83 | $1,071.52 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $3,981.07 Typical High $5,754.40 | Facility | None | $1,202.26 | $3,981.07 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $3,162.28 Typical High $4,570.88 | Professional | None | $831.76 | $3,162.28 | $4,570.88 |
Premera BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $6,025.60 Typical High $6,918.31 | Facility | None | $5,754.40 | $6,025.60 | $6,918.31 |
Premera BCBS Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $4,073.80 Median $7,585.78 Typical High $23,988.33 | Facility | None | $4,073.80 | $7,585.78 | $23,988.33 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,096.48 Typical High $2,290.87 | Professional | None | $60.26 | $1,096.48 | $2,290.87 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $24,547.09 | Facility | None | $4,265.80 | $9,772.37 | $24,547.09 |
United Setting Professional Modifier None Typical Low $707.95 Median $2,041.74 Typical High $4,677.35 | Professional | None | $707.95 | $2,041.74 | $4,677.35 |
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 $371.54 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $371.54 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $147.91 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $562.34 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $112.20 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $74.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $524.81 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $416.87 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $165.96 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $616.60 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $123.03 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $83.18 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $575.44 | $2,818.38 | $2,818.38 |
Where Alaska sits
The same service costs 25.1 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
$3,090
AK $3,090TX $123
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.