How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,479 to $10,233Professionalmedian $2,344 · 10th to 90th $1,413 to $3,467
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $9,332.54 Typical High $12,882.50 | Facility | None | $870.96 | $9,332.54 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,318.26 | $2,089.30 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,511.89 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,949.84 | $7,943.28 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,778.28 | $1,778.28 | $2,951.21 |
Pacific Source Setting Facility Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $2,570.40 | Facility | None | $1,479.11 | $2,454.71 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $8,709.64 Typical High $12,022.64 | Facility | None | $1,000.00 | $8,709.64 | $12,022.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,398.83 Typical High $3,715.35 | Professional | None | $79.43 | $2,398.83 | $3,715.35 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,548.13 Median $8,128.31 Typical High $11,220.18 | Facility | None | $3,548.13 | $8,128.31 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $3,311.31 | Professional | None | $2,454.71 | $2,570.40 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,290.87 | $3,801.89 |
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 $724.44 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,096.48 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $218.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Oregon sits
The same service costs 6.1 times more in Alaska than in Texas. 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 $14,041TX $2,290
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.