How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,000 to $251,189Professionalmedian $8,318 · 10th to 90th $2,399 to $12,882
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 $12,882.50 Typical High $16,595.87 | Facility | None | $9,772.37 | $12,882.50 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $12,882.50 Typical High $12,882.50 | Professional | None | $2,398.83 | $12,882.50 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,388.44 Typical High $7,413.10 | Professional | None | $2,137.96 | $3,388.44 | $7,413.10 |
Moda Health Setting Facility Modifier None Typical Low $3,801.89 Median $12,882.50 Typical High $18,620.87 | Facility | None | $3,801.89 | $12,882.50 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $2,454.71 Median $10,000.00 Typical High $14,454.40 | Professional | None | $2,454.71 | $10,000.00 | $14,454.40 |
Premera BCBS Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Providence Setting Facility Modifier None Typical Low $12,882.50 Median $251,188.64 Typical High $346,736.85 | Facility | None | $12,882.50 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $3,467.37 Typical High $7,413.10 | Professional | None | $60.26 | $3,467.37 | $7,413.10 |
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 $2,290.87 Median $6,606.93 Typical High $15,135.61 | Professional | None | $2,290.87 | $6,606.93 | $15,135.61 |
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 $1,202.26 Median $6,456.54 Typical High $6,456.54 | Professional | 52 · Reduced service | $1,202.26 | $6,456.54 | $6,456.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $2,630.27 Typical High $2,630.27 | Professional | 53 · Discontinued | $478.63 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $9,772.37 Typical High $9,772.37 | Professional | 54 · Surgery only | $1,778.28 | $9,772.37 | $9,772.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $1,949.84 Typical High $1,949.84 | Professional | 55 · Aftercare only | $354.81 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $1,288.25 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $239.88 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $9,120.11 Typical High $9,120.11 | Professional | 78 · Unplanned return to OR | $1,659.59 | $9,120.11 | $9,120.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $6,456.54 Typical High $6,456.54 | Professional | 52 · Reduced service | $1,318.26 | $6,456.54 | $6,456.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $2,630.27 Typical High $2,630.27 | Professional | 53 · Discontinued | $537.03 | $2,630.27 | $2,630.27 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $9,772.37 Typical High $9,772.37 | Professional | 54 · Surgery only | $1,995.26 | $9,772.37 | $9,772.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $1,949.84 Typical High $1,949.84 | Professional | 55 · Aftercare only | $398.11 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $1,288.25 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $269.15 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $9,120.11 Typical High $9,120.11 | Professional | 78 · Unplanned return to OR | $1,862.09 | $9,120.11 | $9,120.11 |
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
$8,318
AK $8,318TX $389
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.