How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,096 to $251,189Professionalmedian $1,514 · 10th to 90th $427 to $2,239
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 $2,238.72 Median $12,022.64 Typical High $16,595.87 | Facility | None | $2,238.72 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $2,238.72 Typical High $2,238.72 | Professional | None | $426.58 | $2,238.72 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $1,288.25 | Professional | None | $398.11 | $616.60 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $2,238.72 Typical High $3,235.94 | Facility | None | $676.08 | $2,238.72 | $3,235.94 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $1,778.28 Typical High $2,570.40 | Professional | None | $467.74 | $1,778.28 | $2,570.40 |
Premera BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $2,290.87 Median $251,188.64 Typical High $346,736.85 | Facility | None | $2,290.87 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $616.60 Typical High $1,288.25 | Professional | None | $60.26 | $616.60 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $407.38 Median $1,148.15 Typical High $2,630.27 | Professional | None | $407.38 | $1,148.15 | $2,630.27 |
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 $213.80 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $213.80 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $85.11 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $323.59 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $64.57 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $42.66 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $302.00 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $234.42 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $93.33 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $346.74 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $69.18 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $46.77 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $323.59 | $1,584.89 | $1,584.89 |
Where Alaska sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$1,738
AK $1,738UT $316
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.