How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,000 to $251,189Professionalmedian $3,715 · 10th to 90th $1,047 to $5,495
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 $5,495.41 Median $12,022.64 Typical High $16,595.87 | Facility | None | $5,495.41 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $5,495.41 Typical High $5,495.41 | Professional | None | $1,023.29 | $5,495.41 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,162.28 | Professional | None | $933.25 | $1,445.44 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $1,659.59 Median $5,495.41 Typical High $7,943.28 | Facility | None | $1,659.59 | $5,495.41 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $4,365.16 Typical High $6,309.57 | Professional | None | $1,148.15 | $4,365.16 | $6,309.57 |
Premera BCBS Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Providence Setting Facility Modifier None Typical Low $5,623.41 Median $251,188.64 Typical High $346,736.85 | Facility | None | $5,623.41 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,513.56 Typical High $3,162.28 | Professional | None | $60.26 | $1,513.56 | $3,162.28 |
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 $1,000.00 Median $2,818.38 Typical High $6,456.54 | Professional | None | $1,000.00 | $2,818.38 | $6,456.54 |
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 $512.86 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $512.86 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $204.17 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $758.58 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $151.36 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $102.33 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $707.95 | $3,890.45 | $3,890.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $575.44 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $229.09 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $851.14 | $4,168.69 | $4,168.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $169.82 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $114.82 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $3,890.45 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $794.33 | $3,890.45 | $3,890.45 |
Where Alaska sits
The same service costs 24.5 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
$4,266
AK $4,266TX $174
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.