How much rates vary
Facilitymedian $4,467 · 10th to 90th $2,399 to $12,023Professionalmedian $1,318 · 10th to 90th $398 to $2,138
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 $2,137.96 Median $10,000.00 Typical High $16,982.44 | Facility | None | $2,137.96 | $10,000.00 | $16,982.44 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $2,137.96 Typical High $2,137.96 | Professional | None | $380.19 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $4,466.84 Typical High $13,803.84 | Facility | None | $2,691.53 | $4,466.84 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $1,230.27 | Professional | None | $371.54 | $562.34 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $2,041.74 Typical High $3,090.30 | Facility | None | $660.69 | $2,041.74 | $3,090.30 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $1,445.44 Typical High $2,511.89 | Professional | None | $407.38 | $1,445.44 | $2,511.89 |
Premera BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $5,623.41 | Facility | None | $3,019.95 | $4,168.69 | $5,623.41 |
Premera BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $2,238.72 Median $4,365.16 Typical High $13,803.84 | Facility | None | $2,238.72 | $4,365.16 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $588.84 Typical High $1,230.27 | Professional | None | $60.26 | $588.84 | $1,230.27 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $7,079.46 Typical High $10,471.29 | Facility | None | $2,570.40 | $7,079.46 | $10,471.29 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,071.52 Typical High $2,511.89 | Professional | None | $380.19 | $1,071.52 | $2,511.89 |
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 $194.98 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $194.98 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $79.43 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $295.12 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $58.88 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $39.81 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $275.42 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $218.78 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $89.13 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $331.13 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $66.07 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $43.65 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $309.03 | $1,513.56 | $1,513.56 |
Where Alaska sits
The same service costs 5.6 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
$1,660
AK $1,660UT $295
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.