How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,000 to $251,189Professionalmedian $7,762 · 10th to 90th $2,291 to $12,023
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 $9,772.37 Median $12,022.64 Typical High $16,595.87 | Facility | None | $9,772.37 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $12,022.64 Typical High $12,022.64 | Professional | None | $2,290.87 | $12,022.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $6,760.83 | Professional | None | $1,995.26 | $3,162.28 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $3,548.13 Median $12,022.64 Typical High $17,378.01 | Facility | None | $3,548.13 | $12,022.64 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $2,511.89 Median $9,332.54 Typical High $13,489.63 | Professional | None | $2,511.89 | $9,332.54 | $13,489.63 |
Premera BCBS Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | None | $9,332.54 | $9,332.54 | $9,332.54 |
Providence Setting Facility Modifier None Typical Low $12,022.64 Median $251,188.64 Typical High $346,736.85 | Facility | None | $12,022.64 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $3,311.31 Typical High $6,760.83 | Professional | None | $60.26 | $3,311.31 | $6,760.83 |
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 $2,187.76 Median $6,165.95 Typical High $14,125.38 | Professional | None | $2,187.76 | $6,165.95 | $14,125.38 |
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 $1,148.15 Median $6,025.60 Typical High $6,025.60 | Professional | 52 · Reduced service | $1,148.15 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $2,454.71 Typical High $2,454.71 | Professional | 53 · Discontinued | $457.09 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $9,120.11 Typical High $9,120.11 | Professional | 54 · Surgery only | $1,698.24 | $9,120.11 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $1,819.70 Typical High $1,819.70 | Professional | 55 · Aftercare only | $338.84 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $1,202.26 Typical High $1,202.26 | Professional | 56 · Pre-op care only | $229.09 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $8,511.38 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $1,584.89 | $8,511.38 | $8,511.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,258.93 Median $6,025.60 Typical High $6,025.60 | Professional | 52 · Reduced service | $1,258.93 | $6,025.60 | $6,025.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $2,454.71 Typical High $2,454.71 | Professional | 53 · Discontinued | $501.19 | $2,454.71 | $2,454.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $9,120.11 Typical High $9,120.11 | Professional | 54 · Surgery only | $1,862.09 | $9,120.11 | $9,120.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $1,819.70 Typical High $1,819.70 | Professional | 55 · Aftercare only | $371.54 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $1,202.26 Typical High $1,202.26 | Professional | 56 · Pre-op care only | $251.19 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $8,511.38 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $1,737.80 | $8,511.38 | $8,511.38 |
Where Alaska sits
The same service costs 22.4 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
$7,943
AK $7,943TX $355
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.