How much rates vary
Facilitymedian $4,467 · 10th to 90th $2,692 to $12,023Professionalmedian $2,042 · 10th to 90th $617 to $3,236
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 $2,344.23 Median $10,000.00 Typical High $16,982.44 | Facility | None | $2,344.23 | $10,000.00 | $16,982.44 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $3,235.94 Typical High $3,235.94 | Professional | None | $602.56 | $3,235.94 | $3,235.94 |
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 $524.81 Median $851.14 Typical High $1,862.09 | Professional | None | $524.81 | $851.14 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $3,235.94 Typical High $4,570.88 | Facility | None | $977.24 | $3,235.94 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $2,570.40 Typical High $3,715.35 | Professional | None | $660.69 | $2,570.40 | $3,715.35 |
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 $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Providence 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 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $851.14 Typical High $1,862.09 | Professional | None | $60.26 | $851.14 | $1,862.09 |
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 $575.44 Median $1,621.81 Typical High $3,715.35 | Professional | None | $575.44 | $1,621.81 | $3,715.35 |
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 $295.12 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $295.12 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $117.49 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $446.68 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $89.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $58.88 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $416.87 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $331.13 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $131.83 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $501.19 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $100.00 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $66.07 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $467.74 | $2,238.72 | $2,238.72 |
Where Alaska sits
The same service costs 5.9 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
$2,512
AK $2,512TX $427
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.