How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,000 to $251,189Professionalmedian $4,898 · 10th to 90th $1,380 to $7,413
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 $7,413.10 Median $12,022.64 Typical High $16,595.87 | Facility | None | $7,413.10 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $7,413.10 Typical High $7,413.10 | Professional | None | $1,380.38 | $7,413.10 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $4,265.80 | Professional | None | $1,202.26 | $1,949.84 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $2,187.76 Median $7,413.10 Typical High $10,715.19 | Facility | None | $2,187.76 | $7,413.10 | $10,715.19 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $5,754.40 Typical High $8,317.64 | Professional | None | $1,513.56 | $5,754.40 | $8,317.64 |
Premera BCBS Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Providence Setting Facility Modifier None Typical Low $7,413.10 Median $251,188.64 Typical High $346,736.85 | Facility | None | $7,413.10 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,995.26 Typical High $4,265.80 | Professional | None | $60.26 | $1,995.26 | $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 $1,318.26 Median $3,801.89 Typical High $8,709.64 | Professional | None | $1,318.26 | $3,801.89 | $8,709.64 |
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 $691.83 Median $3,715.35 Typical High $3,715.35 | Professional | 52 · Reduced service | $691.83 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $1,479.11 Typical High $1,479.11 | Professional | 53 · Discontinued | $275.42 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $5,623.41 Typical High $5,623.41 | Professional | 54 · Surgery only | $1,047.13 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $1,122.02 Typical High $1,122.02 | Professional | 55 · Aftercare only | $208.93 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $741.31 Typical High $741.31 | Professional | 56 · Pre-op care only | $138.04 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $5,248.07 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $977.24 | $5,248.07 | $5,248.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $3,715.35 Typical High $3,715.35 | Professional | 52 · Reduced service | $758.58 | $3,715.35 | $3,715.35 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $1,479.11 Typical High $1,479.11 | Professional | 53 · Discontinued | $309.03 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $5,623.41 Typical High $5,623.41 | Professional | 54 · Surgery only | $1,148.15 | $5,623.41 | $5,623.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $1,122.02 Typical High $1,122.02 | Professional | 55 · Aftercare only | $229.09 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $741.31 Typical High $741.31 | Professional | 56 · Pre-op care only | $151.36 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $5,248.07 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $1,071.52 | $5,248.07 | $5,248.07 |
Where Alaska sits
The same service costs 5.2 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
$4,898
AK $4,898TX $933
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.