How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,995 to $8,913Professionalmedian $1,318 · 10th to 90th $562 to $4,169
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $1,584.89 Typical High $2,818.38 | Professional | None | $467.74 | $1,584.89 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $3,162.28 Typical High $4,168.69 | Facility | None | $1,071.52 | $3,162.28 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,412.54 Typical High $4,570.88 | Professional | None | $575.44 | $1,412.54 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $4,466.84 | Professional | None | $741.31 | $1,047.13 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $4,073.80 Typical High $18,620.87 | Facility | None | $812.83 | $4,073.80 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $1,659.59 Typical High $3,548.13 | Professional | None | $562.34 | $1,659.59 | $3,548.13 |
Pacific Source Setting Facility Modifier None Typical Low $2,089.30 Median $3,235.94 Typical High $3,548.13 | Facility | None | $2,089.30 | $3,235.94 | $3,548.13 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $3,090.30 Typical High $4,466.84 | Facility | None | $758.58 | $3,090.30 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $1,174.90 Typical High $4,570.88 | Professional | None | $416.87 | $1,174.90 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,481.54 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,481.54 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $3,548.13 | Professional | None | $776.25 | $1,380.38 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,737.80 Typical High $4,677.35 | Professional | None | $602.56 | $1,737.80 | $4,677.35 |
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 $281.84 Median $316.23 Typical High $1,412.54 | Professional | 52 · Reduced service | $281.84 | $316.23 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $562.34 | Professional | 53 · Discontinued | $112.20 | $125.89 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $467.74 Typical High $2,137.96 | Professional | 54 · Surgery only | $426.58 | $467.74 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $426.58 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $281.84 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $436.52 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $398.11 | $436.52 | $1,995.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $1,412.54 | Professional | 52 · Reduced service | $281.84 | $281.84 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $562.34 | Professional | 53 · Discontinued | $112.20 | $112.20 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $2,137.96 | Professional | 54 · Surgery only | $426.58 | $426.58 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $426.58 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $281.84 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $1,995.26 |
Where Oregon sits
The same service costs 4.4 times more in Oklahoma 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
OK $10,373MD $2,367
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.