How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,778 to $39,811Professionalmedian $2,692 · 10th to 90th $1,380 to $4,074
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 $2,570.40 Median $15,488.17 Typical High $33,884.42 | Facility | None | $2,570.40 | $15,488.17 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $2,187.76 | Professional | None | $1,380.38 | $2,089.30 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $37,153.52 Typical High $50,118.72 | Facility | None | $870.96 | $37,153.52 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $4,073.80 | Professional | None | $1,548.82 | $2,454.71 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,090.30 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $27.54 Median $3,162.28 Typical High $23,988.33 | Facility | None | $27.54 | $3,162.28 | $23,988.33 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,380.38 | $2,187.76 | $3,467.37 |
Pacific Source Setting Facility Modifier None Typical Low $1,778.28 Median $2,818.38 Typical High $3,090.30 | Facility | None | $1,778.28 | $2,818.38 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $33,884.42 Typical High $48,977.88 | Facility | None | $1,023.29 | $33,884.42 | $48,977.88 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,818.38 Typical High $4,168.69 | Professional | None | $79.43 | $2,818.38 | $4,168.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $16,595.87 Median $42,657.95 Typical High $67,608.30 | Facility | None | $16,595.87 | $42,657.95 | $67,608.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,951.21 Median $3,090.30 Typical High $3,981.07 | Professional | None | $2,951.21 | $3,090.30 | $3,981.07 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $7,762.47 Typical High $50,118.72 | Facility | None | $2,951.21 | $7,762.47 | $50,118.72 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,818.38 Typical High $4,570.88 | Professional | None | $1,778.28 | $2,818.38 | $4,570.88 |
14 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 $870.96 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $870.96 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,318.26 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $263.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $173.78 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $1,621.81 Typical High $4,570.88 | Professional | 62 · Two surgeons | $436.52 | $1,621.81 | $4,570.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $186.21 Typical High $602.56 | Professional | AS · PA/NP assist | $95.50 | $186.21 | $602.56 |
Where Oregon sits
The same service costs 10.6 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 $37,069KY $3,499
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.