How much rates vary
Facilitymedian $1,585 · 10th to 90th $1,072 to $14,125Professionalmedian $1,445 · 10th to 90th $813 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 $1,380.38 Median $12,302.69 Typical High $33,884.42 | Facility | None | $1,380.38 | $12,302.69 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,949.84 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $2,238.72 | Professional | None | $851.14 | $1,318.26 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,584.89 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $19,952.62 | Facility | None | $1,348.96 | $2,238.72 | $19,952.62 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,862.09 | Professional | None | $851.14 | $1,174.90 | $1,862.09 |
Pacific Source Setting Facility Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,621.81 | Facility | None | $933.25 | $1,479.11 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $1,513.56 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,513.56 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,479.11 Typical High $2,238.72 | Professional | None | $79.43 | $1,479.11 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,621.81 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,344.23 | Professional | None | $912.01 | $1,412.54 | $2,344.23 |
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 $457.09 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $21,877.62 Median $30,199.52 Typical High $34,673.69 | Facility | 50 · Both sides | $21,877.62 | $30,199.52 | $34,673.69 |
Where Oregon sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $10,315KY $2,095
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.