How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,000 to $251,189Professionalmedian $6,026 · 10th to 90th $1,738 to $9,120
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 $9,120.11 Median $12,022.64 Typical High $16,595.87 | Facility | None | $9,120.11 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $9,120.11 Typical High $9,120.11 | Professional | None | $1,659.59 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $5,128.61 | Professional | None | $1,548.82 | $2,398.83 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $2,691.53 Median $9,120.11 Typical High $13,182.57 | Facility | None | $2,691.53 | $9,120.11 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $7,079.46 Typical High $10,232.93 | Professional | None | $1,862.09 | $7,079.46 | $10,232.93 |
Premera BCBS Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
Providence Setting Facility Modifier None Typical Low $9,120.11 Median $251,188.64 Typical High $346,736.85 | Facility | None | $9,120.11 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $2,454.71 Typical High $5,128.61 | Professional | None | $60.26 | $2,454.71 | $5,128.61 |
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 $1,621.81 Median $4,677.35 Typical High $10,715.19 | Professional | None | $1,621.81 | $4,677.35 | $10,715.19 |
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 $831.76 Median $4,570.88 Typical High $4,570.88 | Professional | 52 · Reduced service | $831.76 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $1,819.70 Typical High $1,819.70 | Professional | 53 · Discontinued | $331.13 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $6,918.31 Typical High $6,918.31 | Professional | 54 · Surgery only | $1,258.93 | $6,918.31 | $6,918.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $1,380.38 Typical High $1,380.38 | Professional | 55 · Aftercare only | $251.19 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $912.01 Typical High $912.01 | Professional | 56 · Pre-op care only | $165.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $6,456.54 Typical High $6,456.54 | Professional | 78 · Unplanned return to OR | $1,174.90 | $6,456.54 | $6,456.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $4,570.88 Typical High $4,570.88 | Professional | 52 · Reduced service | $933.25 | $4,570.88 | $4,570.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $1,819.70 Typical High $1,819.70 | Professional | 53 · Discontinued | $371.54 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $6,918.31 Typical High $6,918.31 | Professional | 54 · Surgery only | $1,412.54 | $6,918.31 | $6,918.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $1,380.38 Typical High $1,380.38 | Professional | 55 · Aftercare only | $281.84 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $912.01 Typical High $912.01 | Professional | 56 · Pre-op care only | $186.21 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $6,456.54 Typical High $6,456.54 | Professional | 78 · Unplanned return to OR | $1,318.26 | $6,456.54 | $6,456.54 |
Where Alaska sits
The same service costs 5.4 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
$6,026
AK $6,026TX $1,122
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.