How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,000 to $251,189Professionalmedian $5,754 · 10th to 90th $1,698 to $8,913
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 $8,912.51 Median $12,022.64 Typical High $16,595.87 | Facility | None | $8,912.51 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $8,912.51 Typical High $8,912.51 | Professional | None | $1,621.81 | $8,912.51 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $5,128.61 | Professional | None | $1,479.11 | $2,344.23 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $2,691.53 Median $8,912.51 Typical High $12,882.50 | Facility | None | $2,691.53 | $8,912.51 | $12,882.50 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $6,918.31 Typical High $10,000.00 | Professional | None | $1,862.09 | $6,918.31 | $10,000.00 |
Premera BCBS Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Providence Setting Facility Modifier None Typical Low $9,120.11 Median $251,188.64 Typical High $346,736.85 | Facility | None | $9,120.11 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $2,398.83 Typical High $5,128.61 | Professional | None | $60.26 | $2,398.83 | $5,128.61 |
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 $1,584.89 Median $4,570.88 Typical High $10,471.29 | Professional | None | $1,584.89 | $4,570.88 | $10,471.29 |
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 $831.76 Median $4,466.84 Typical High $4,466.84 | Professional | 52 · Reduced service | $831.76 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $1,819.70 Typical High $1,819.70 | Professional | 53 · Discontinued | $331.13 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $6,760.83 Typical High $6,760.83 | Professional | 54 · Surgery only | $1,230.27 | $6,760.83 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $1,348.96 Typical High $1,348.96 | Professional | 55 · Aftercare only | $251.19 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $891.25 Typical High $891.25 | Professional | 56 · Pre-op care only | $165.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $6,309.57 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $1,148.15 | $6,309.57 | $6,309.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $4,466.84 Typical High $4,466.84 | Professional | 52 · Reduced service | $933.25 | $4,466.84 | $4,466.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $1,819.70 Typical High $1,819.70 | Professional | 53 · Discontinued | $371.54 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $6,760.83 Typical High $6,760.83 | Professional | 54 · Surgery only | $1,380.38 | $6,760.83 | $6,760.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $1,348.96 Typical High $1,348.96 | Professional | 55 · Aftercare only | $275.42 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $891.25 Typical High $891.25 | Professional | 56 · Pre-op care only | $186.21 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $6,309.57 Typical High $6,309.57 | Professional | 78 · Unplanned return to OR | $1,288.25 | $6,309.57 | $6,309.57 |
Where Alaska sits
The same service costs 5.4 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
$5,888
AK $5,888TX $1,096
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.