How much rates vary
Facilitymedian $1,175 · 10th to 90th $813 to $9,772Professionalmedian $1,047 · 10th to 90th $589 to $1,622
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 $1,023.29 Median $10,232.93 Typical High $24,547.09 | Facility | None | $1,023.29 | $10,232.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $933.25 | Professional | None | $588.84 | $831.76 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $3,162.28 Typical High $4,168.69 | Facility | None | $1,412.54 | $3,162.28 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,659.59 | Professional | None | $630.96 | $1,000.00 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,258.93 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $7,943.28 Typical High $15,848.93 | Facility | None | $1,023.29 | $7,943.28 | $15,848.93 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,513.56 | Professional | None | $707.95 | $933.25 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,202.26 | Facility | None | $676.08 | $1,122.02 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $1,174.90 Median $2,818.38 Typical High $4,168.69 | Facility | None | $1,174.90 | $2,818.38 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,071.52 Typical High $1,659.59 | Professional | None | $79.43 | $1,071.52 | $1,659.59 |
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 $1,148.15 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,202.26 | $1,548.82 |
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 $676.08 Median $1,047.13 Typical High $1,737.80 | Professional | None | $676.08 | $1,047.13 | $1,737.80 |
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 $338.84 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $16,982.44 Typical High $19,498.45 | Facility | 50 · Both sides | $12,302.69 | $16,982.44 | $19,498.45 |
Where Oregon sits
The same service costs 3.9 times more in Wisconsin than in Montana. 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
WI $7,471MT $1,932
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.