How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,000 to $251,189Professionalmedian $4,571 · 10th to 90th $1,288 to $6,918
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 $6,918.31 Median $12,022.64 Typical High $16,595.87 | Facility | None | $6,918.31 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $6,918.31 Typical High $6,918.31 | Professional | None | $1,288.25 | $6,918.31 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $3,890.45 | Professional | None | $1,122.02 | $1,819.70 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $6,918.31 Typical High $9,772.37 | Facility | None | $2,041.74 | $6,918.31 | $9,772.37 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $5,370.32 Typical High $7,762.47 | Professional | None | $1,412.54 | $5,370.32 | $7,762.47 |
Premera BCBS Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Providence Setting Facility Modifier None Typical Low $6,918.31 Median $251,188.64 Typical High $346,736.85 | Facility | None | $6,918.31 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,862.09 Typical High $3,890.45 | Professional | None | $60.26 | $1,862.09 | $3,890.45 |
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 $1,230.27 Median $3,548.13 Typical High $8,128.31 | Professional | None | $1,230.27 | $3,548.13 | $8,128.31 |
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 $630.96 Median $3,467.37 Typical High $3,467.37 | Professional | 52 · Reduced service | $630.96 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $257.04 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $5,128.61 Typical High $5,128.61 | Professional | 54 · Surgery only | $954.99 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $1,023.29 Typical High $1,023.29 | Professional | 55 · Aftercare only | $190.55 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $128.82 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $4,786.30 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $891.25 | $4,786.30 | $4,786.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $3,467.37 Typical High $3,467.37 | Professional | 52 · Reduced service | $707.95 | $3,467.37 | $3,467.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $281.84 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $5,128.61 Typical High $5,128.61 | Professional | 54 · Surgery only | $1,071.52 | $5,128.61 | $5,128.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $1,023.29 Typical High $1,023.29 | Professional | 55 · Aftercare only | $213.80 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $141.25 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $4,786.30 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $1,000.00 | $4,786.30 | $4,786.30 |
Where Alaska sits
The same service costs 21.4 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
$4,571
AK $4,571TX $214
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.