How much rates vary
Facilitymedian $1,122 · 10th to 90th $724 to $9,550Professionalmedian $933 · 10th to 90th $468 to $1,549
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 $870.96 Median $5,128.61 Typical High $13,182.57 | Facility | None | $870.96 | $5,128.61 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $977.24 | Professional | None | $398.11 | $630.96 | $977.24 |
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 $676.08 Median $954.99 Typical High $1,548.82 | Professional | None | $676.08 | $954.99 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,513.56 | Professional | None | $851.14 | $1,174.90 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,905.46 Typical High $13,489.63 | Facility | None | $870.96 | $1,905.46 | $13,489.63 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $1,348.96 | Professional | None | $446.68 | $794.33 | $1,348.96 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,148.15 | Facility | None | $645.65 | $1,047.13 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $2,511.89 Typical High $4,073.80 | Facility | None | $870.96 | $2,511.89 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,000.00 Typical High $1,548.82 | Professional | None | $79.43 | $1,000.00 | $1,548.82 |
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 $891.25 Median $1,148.15 Typical High $1,548.82 | Professional | None | $891.25 | $1,148.15 | $1,548.82 |
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 $707.95 Median $1,071.52 Typical High $1,698.24 | Professional | None | $707.95 | $1,071.52 | $1,698.24 |
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 $275.42 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $275.42 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $125.89 Typical High $158.49 | Professional | 53 · Discontinued | $109.65 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $602.56 | Professional | 54 · Surgery only | $416.87 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $83.18 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $63.10 Typical High $79.43 | Professional | 56 · Pre-op care only | $54.95 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $316.23 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $125.89 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | 54 · Surgery only | $478.63 | $478.63 | $602.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $79.43 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $562.34 |
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 4.7 times more in Vermont than in Montana. 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 $7,643MT $1,633
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.