How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,000 to $251,189Professionalmedian $3,981 · 10th to 90th $1,148 to $6,026
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 $6,025.60 Median $12,022.64 Typical High $16,595.87 | Facility | None | $6,025.60 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $6,025.60 Typical High $6,025.60 | Professional | None | $1,122.02 | $6,025.60 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $3,467.37 | Professional | None | $1,000.00 | $1,584.89 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $1,819.70 Median $6,025.60 Typical High $8,709.64 | Facility | None | $1,819.70 | $6,025.60 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $4,677.35 Typical High $6,918.31 | Professional | None | $1,258.93 | $4,677.35 | $6,918.31 |
Premera BCBS Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Providence Setting Facility Modifier None Typical Low $6,165.95 Median $251,188.64 Typical High $346,736.85 | Facility | None | $6,165.95 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,659.59 Typical High $3,467.37 | Professional | None | $60.26 | $1,659.59 | $3,467.37 |
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 $1,071.52 Median $3,090.30 Typical High $7,079.46 | Professional | None | $1,071.52 | $3,090.30 | $7,079.46 |
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 $549.54 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $549.54 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $223.87 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $831.76 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $165.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $112.20 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $4,265.80 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $776.25 | $4,265.80 | $4,265.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $616.60 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $251.19 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $933.25 | $4,570.88 | $4,570.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $186.21 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $125.89 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $4,265.80 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $870.96 | $4,265.80 | $4,265.80 |
Where Alaska sits
The same service costs 5.6 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 $759
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.