How much rates vary
Facilitymedian $794 · 10th to 90th $427 to $1,660Professionalmedian $617 · 10th to 90th $347 to $1,072
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $478.63 Median $5,623.41 Typical High $8,709.64 | Facility | None | $478.63 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $616.60 | Professional | None | $239.88 | $389.05 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $812.83 Typical High $1,047.13 | Facility | None | $616.60 | $812.83 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $1,148.15 | Professional | None | $407.38 | $645.65 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $1,148.15 | Professional | None | $489.78 | $660.69 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $812.83 Typical High $7,943.28 | Facility | None | $478.63 | $812.83 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $912.01 | Professional | None | $346.74 | $549.54 | $912.01 |
Pacific Source Setting Facility Modifier None Typical Low $489.78 Median $794.33 Typical High $870.96 | Facility | None | $489.78 | $794.33 | $870.96 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $812.83 Typical High $1,122.02 | Facility | None | $562.34 | $812.83 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $645.65 Typical High $1,096.48 | Professional | None | $79.43 | $645.65 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $2,511.89 | Facility | None | $1,479.11 | $2,137.96 | $2,511.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $891.25 | Professional | None | $537.03 | $812.83 | $891.25 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $416.87 Median $707.95 Typical High $1,174.90 | Professional | None | $416.87 | $707.95 | $1,174.90 |
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 $162.18 Median $194.98 Typical High $309.03 | Professional | 52 · Reduced service | $162.18 | $194.98 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $77.62 Typical High $125.89 | Professional | 53 · Discontinued | $64.57 | $77.62 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $288.40 Typical High $467.74 | Professional | 54 · Surgery only | $245.47 | $288.40 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $93.33 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.90 Typical High $61.66 | Professional | 56 · Pre-op care only | $32.36 | $38.90 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $269.15 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $229.09 | $269.15 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $194.98 Typical High $309.03 | Professional | 52 · Reduced service | $162.18 | $194.98 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $77.62 Typical High $125.89 | Professional | 53 · Discontinued | $64.57 | $77.62 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $288.40 Typical High $467.74 | Professional | 54 · Surgery only | $245.47 | $288.40 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $93.33 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.90 Typical High $61.66 | Professional | 56 · Pre-op care only | $32.36 | $38.90 | $61.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $269.15 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $229.09 | $269.15 | $436.52 |
Where Oregon sits
The same service costs 4.1 times more in New York than in Maryland. 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.
Physician feeFacility fee
NY $3,010MD $740
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.