How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,585 to $8,913Professionalmedian $2,754 · 10th to 90th $1,413 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 $5,128.61 Median $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,905.46 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $6,918.31 Typical High $9,549.93 | Facility | None | $870.96 | $6,918.31 | $9,549.93 |
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 $2,570.40 Median $3,019.95 Typical High $3,630.78 | Professional | None | $2,570.40 | $3,019.95 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $2,089.30 Median $4,168.69 Typical High $24,547.09 | Facility | None | $2,089.30 | $4,168.69 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,479.11 | $2,089.30 | $3,388.44 |
Pacific Source Setting Facility Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $3,019.95 | Facility | None | $1,513.56 | $2,754.23 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $6,165.95 Typical High $8,912.51 | Facility | None | $1,023.29 | $6,165.95 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,691.53 Typical High $4,168.69 | Professional | None | $79.43 | $2,691.53 | $4,168.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $21,379.62 Typical High $29,512.09 | Facility | None | $7,585.78 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,884.03 | $3,019.95 | $3,981.07 |
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 $1,737.80 Median $2,691.53 Typical High $4,466.84 | Professional | None | $1,737.80 | $2,691.53 | $4,466.84 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $851.14 | $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 $1,288.25 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,288.25 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $169.82 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,202.26 | $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 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 |
Where Oregon sits
The same service costs 5.5 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 $15,938KY $2,890
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.