How much rates vary
Facilitymedian $4,467 · 10th to 90th $2,692 to $12,023Professionalmedian $1,950 · 10th to 90th $603 to $3,162
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 $588.84 Median $3,162.28 Typical High $3,162.28 | Professional | None | $588.84 | $3,162.28 | $3,162.28 |
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 $1,819.70 | Professional | None | $524.81 | $851.14 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $3,162.28 Typical High $4,570.88 | Facility | None | $954.99 | $3,162.28 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $2,137.96 Typical High $3,715.35 | Professional | None | $616.60 | $2,137.96 | $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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $870.96 Typical High $1,819.70 | Professional | None | $60.26 | $870.96 | $1,819.70 |
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 $562.34 Median $1,621.81 Typical High $3,715.35 | Professional | None | $562.34 | $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 $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $295.12 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $117.49 | $630.96 | $630.96 |
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 $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $58.88 | $316.23 | $316.23 |
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 $323.59 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $323.59 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $131.83 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $489.78 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $97.72 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $66.07 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $457.09 | $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
$2,455
AK $2,455TX $417
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.