How much rates vary
Facilitymedian $1,698 · 10th to 90th $1,148 to $9,550Professionalmedian $1,585 · 10th to 90th $891 to $2,399
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 $851.14 Median $1,202.26 Typical High $1,202.26 | Professional | None | $851.14 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $6,918.31 Typical High $9,549.93 | Facility | None | $2,630.27 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,398.83 | Professional | None | $933.25 | $1,479.11 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,621.81 | $1,905.46 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,570.40 Typical High $17,378.01 | Facility | None | $1,318.26 | $2,570.40 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,348.96 | $2,041.74 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $1,778.28 | Facility | None | $1,000.00 | $1,659.59 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $9,549.93 | Facility | None | $1,698.24 | $6,456.54 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $2,398.83 | Professional | None | $79.43 | $1,584.89 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $25,118.86 Typical High $28,183.83 | Facility | None | $8,912.51 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,778.28 | $2,290.87 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,548.82 | $2,630.27 |
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 $489.78 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $741.31 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $691.83 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Where Oregon sits
The same service costs 5.1 times more in Oklahoma 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
OK $11,738KY $2,311
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.