How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,072 to $251,189Professionalmedian $2,692 · 10th to 90th $776 to $4,074
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 $14,125.38 Typical High $22,387.21 | Facility | None | $2,344.23 | $14,125.38 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $4,073.80 Typical High $4,073.80 | Professional | None | $758.58 | $4,073.80 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $2,344.23 | Professional | None | $691.83 | $1,071.52 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $4,073.80 Typical High $5,888.44 | Facility | None | $1,230.27 | $4,073.80 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $3,162.28 Typical High $4,677.35 | Professional | None | $831.76 | $3,162.28 | $4,677.35 |
Premera BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $6,309.57 Typical High $8,912.51 | Facility | None | $4,466.84 | $6,309.57 | $8,912.51 |
Premera BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Providence Setting Facility Modifier None Typical Low $4,168.69 Median $251,188.64 Typical High $346,736.85 | Facility | None | $4,168.69 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,096.48 Typical High $2,344.23 | Professional | None | $60.26 | $1,096.48 | $2,344.23 |
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 $724.44 Median $2,089.30 Typical High $4,786.30 | Professional | None | $724.44 | $2,089.30 | $4,786.30 |
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 $380.19 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $380.19 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $151.36 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $575.44 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $114.82 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $75.86 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $537.03 | $2,884.03 | $2,884.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $416.87 | $2,041.74 | $2,041.74 |
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 $630.96 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $630.96 | $3,090.30 | $3,090.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $125.89 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $83.18 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $588.84 | $2,884.03 | $2,884.03 |
Where Alaska sits
The same service costs 5.9 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
$3,162
AK $3,162TX $537
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.