How much rates vary
Facilitymedian $1,023 · 10th to 90th $676 to $10,233Professionalmedian $851 · 10th to 90th $417 to $1,380
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 $707.95 Median $5,128.61 Typical High $17,378.01 | Facility | None | $707.95 | $5,128.61 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $575.44 Typical High $891.25 | Professional | None | $354.81 | $575.44 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $4,073.80 | Facility | None | $1,000.00 | $3,019.95 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,412.54 | Professional | None | $602.56 | $870.96 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,380.38 | Professional | None | $776.25 | $1,071.52 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $13,803.84 | Facility | None | $741.31 | $2,818.38 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $1,230.27 | Professional | None | $398.11 | $707.95 | $1,230.27 |
Pacific Source Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $1,047.13 | Facility | None | $588.84 | $933.25 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,454.71 Typical High $4,073.80 | Facility | None | $812.83 | $2,454.71 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $891.25 Typical High $1,380.38 | Professional | None | $79.43 | $891.25 | $1,380.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,120.11 Median $12,882.50 Typical High $15,135.61 | Facility | None | $9,120.11 | $12,882.50 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,412.54 | Professional | None | $812.83 | $1,047.13 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,548.82 | Professional | None | $630.96 | $977.24 | $1,548.82 |
13 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 $251.19 Median $288.40 Typical High $363.08 | Professional | 52 · Reduced service | $251.19 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $114.82 Typical High $144.54 | Professional | 53 · Discontinued | $100.00 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $549.54 | Professional | 54 · Surgery only | $371.54 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $109.65 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $50.12 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | 52 · Reduced service | $288.40 | $288.40 | $363.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $144.54 | Professional | 53 · Discontinued | $114.82 | $114.82 | $144.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $426.58 | $549.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $72.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $512.86 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,489.63 Median $19,498.45 Typical High $22,908.68 | Facility | 50 · Both sides | $13,489.63 | $19,498.45 | $22,908.68 |
Where Oregon sits
The same service costs 7.2 times more in Vermont than in Maine. 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
VT $9,370ME $1,294
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.