How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,000 to $251,189Professionalmedian $14,125 · 10th to 90th $4,169 to $22,387
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 $14,125.38 Typical High $22,387.21 | Facility | None | $9,772.37 | $14,125.38 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $22,387.21 Typical High $22,387.21 | Professional | None | $3,981.07 | $22,387.21 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $5,623.41 Typical High $12,589.25 | Professional | None | $3,630.78 | $5,623.41 | $12,589.25 |
Moda Health Setting Facility Modifier None Typical Low $6,606.93 Median $22,387.21 Typical High $31,622.78 | Facility | None | $6,606.93 | $22,387.21 | $31,622.78 |
Moda Health Setting Professional Modifier None Typical Low $4,570.88 Median $16,982.44 Typical High $24,547.09 | Professional | None | $4,570.88 | $16,982.44 | $24,547.09 |
Premera BCBS Setting Professional Modifier None Typical Low $16,982.44 Median $16,982.44 Typical High $16,982.44 | Professional | None | $16,982.44 | $16,982.44 | $16,982.44 |
Providence Setting Facility Modifier None Typical Low $22,387.21 Median $251,188.64 Typical High $346,736.85 | Facility | None | $22,387.21 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $5,888.44 Typical High $12,589.25 | Professional | None | $60.26 | $5,888.44 | $12,589.25 |
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 $3,981.07 Median $11,220.18 Typical High $25,703.96 | Professional | None | $3,981.07 | $11,220.18 | $25,703.96 |
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 $1,995.26 Median $11,220.18 Typical High $11,220.18 | Professional | 52 · Reduced service | $1,995.26 | $11,220.18 | $11,220.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $4,466.84 Typical High $4,466.84 | Professional | 53 · Discontinued | $812.83 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $16,595.87 Typical High $16,595.87 | Professional | 54 · Surgery only | $3,019.95 | $16,595.87 | $16,595.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $3,311.31 Typical High $3,311.31 | Professional | 55 · Aftercare only | $602.56 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $2,238.72 Typical High $2,238.72 | Professional | 56 · Pre-op care only | $398.11 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $15,488.17 Typical High $15,488.17 | Professional | 78 · Unplanned return to OR | $2,818.38 | $15,488.17 | $15,488.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,290.87 Median $11,220.18 Typical High $11,220.18 | Professional | 52 · Reduced service | $2,290.87 | $11,220.18 | $11,220.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $4,466.84 Typical High $4,466.84 | Professional | 53 · Discontinued | $912.01 | $4,466.84 | $4,466.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $16,595.87 Typical High $16,595.87 | Professional | 54 · Surgery only | $3,388.44 | $16,595.87 | $16,595.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $3,311.31 Typical High $3,311.31 | Professional | 55 · Aftercare only | $676.08 | $3,311.31 | $3,311.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $2,238.72 Typical High $2,238.72 | Professional | 56 · Pre-op care only | $457.09 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $15,488.17 Typical High $15,488.17 | Professional | 78 · Unplanned return to OR | $3,162.28 | $15,488.17 | $15,488.17 |
Where Alaska sits
The same service costs 21.9 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
$14,125
AK $14,125TX $646
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.