How much rates vary
Facilitymedian $1,622 · 10th to 90th $977 to $5,248Professionalmedian $1,288 · 10th to 90th $794 to $2,188
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 $5,128.61 Median $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,202.26 | Professional | None | $660.69 | $933.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $2,884.03 | Facility | None | $1,000.00 | $2,187.76 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,290.87 | Professional | None | $977.24 | $1,288.25 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,445.44 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $13,182.57 | Facility | None | $1,023.29 | $1,698.24 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,737.80 | Professional | None | $724.44 | $1,202.26 | $1,737.80 |
Pacific Source Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $1,698.24 | Facility | None | $954.99 | $1,584.89 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $2,884.03 | Facility | None | $977.24 | $1,949.84 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,318.26 Typical High $2,238.72 | Professional | None | $79.43 | $1,318.26 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $7,413.10 | Facility | None | $4,786.30 | $6,456.54 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,621.81 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,344.23 | Professional | None | $954.99 | $1,445.44 | $2,344.23 |
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 $331.13 Median $467.74 Typical High $588.84 | Professional | 52 · Reduced service | $331.13 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $186.21 Typical High $239.88 | Professional | 53 · Discontinued | $131.83 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $691.83 Typical High $891.25 | Professional | 54 · Surgery only | $489.78 | $691.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $100.00 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $93.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $66.07 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $645.65 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $457.09 | $645.65 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $467.74 Typical High $588.84 | Professional | 52 · Reduced service | $331.13 | $467.74 | $588.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $186.21 Typical High $239.88 | Professional | 53 · Discontinued | $131.83 | $186.21 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $691.83 Typical High $891.25 | Professional | 54 · Surgery only | $489.78 | $691.83 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $100.00 | $141.25 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $93.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $66.07 | $93.33 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $645.65 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $457.09 | $645.65 | $831.76 |
Where Oregon sits
The same service costs 3.1 times more in Alaska 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
AK $5,990MD $1,938
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.