How much rates vary
Facilitymedian $10,715 · 10th to 90th $4,074 to $15,849Professionalmedian $1,660 · 10th to 90th $708 to $14,454
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 $11,748.98 Typical High $24,547.09 | Facility | None | $870.96 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $4,897.79 Typical High $9,772.37 | Professional | None | $562.34 | $4,897.79 | $9,772.37 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,079.46 Typical High $9,549.93 | Facility | None | $1,000.00 | $7,079.46 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,905.46 Typical High $14,791.08 | Professional | None | $724.44 | $1,905.46 | $14,791.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $14,791.08 | Professional | None | $912.01 | $1,318.26 | $14,791.08 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $12,022.64 Typical High $19,952.62 | Facility | None | $870.96 | $12,022.64 | $19,952.62 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $5,623.41 Typical High $11,748.98 | Professional | None | $707.95 | $5,623.41 | $11,748.98 |
Pacific Source Setting Facility Modifier None Typical Low $7,585.78 Median $10,715.19 Typical High $13,803.84 | Facility | None | $7,585.78 | $10,715.19 | $13,803.84 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $7,079.46 Typical High $11,748.98 | Facility | None | $870.96 | $7,079.46 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $1,479.11 Typical High $15,135.61 | Professional | None | $512.86 | $1,479.11 | $15,135.61 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $977.24 Median $1,737.80 Typical High $11,220.18 | Professional | None | $977.24 | $1,737.80 | $11,220.18 |
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 $776.25 Median $5,495.41 Typical High $15,135.61 | Professional | None | $776.25 | $5,495.41 | $15,135.61 |
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 $354.81 Median $398.11 Typical High $4,897.79 | Professional | 52 · Reduced service | $354.81 | $398.11 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $162.18 Typical High $1,995.26 | Professional | 53 · Discontinued | $141.25 | $162.18 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $602.56 Typical High $7,413.10 | Professional | 54 · Surgery only | $524.81 | $602.56 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $1,479.11 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $977.24 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $562.34 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $489.78 | $562.34 | $6,918.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $354.81 Typical High $4,897.79 | Professional | 52 · Reduced service | $354.81 | $354.81 | $4,897.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $1,995.26 | Professional | 53 · Discontinued | $141.25 | $141.25 | $1,995.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $7,413.10 | Professional | 54 · Surgery only | $524.81 | $524.81 | $7,413.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $1,479.11 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $1,479.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $977.24 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $977.24 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $6,918.31 |
Where Oregon sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,493
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.