How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,000 to $6,026Professionalmedian $2,239 · 10th to 90th $912 to $3,388
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $4,168.69 | Facility | None | $891.25 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,318.26 | $2,041.74 | $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 $1,096.48 Median $3,019.95 Typical High $8,709.64 | Facility | None | $1,096.48 | $3,019.95 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,737.80 | $2,754.23 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $2,344.23 Typical High $2,511.89 | Facility | None | $1,000.00 | $2,344.23 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $2,951.21 Typical High $4,168.69 | Facility | None | $912.01 | $2,951.21 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,089.30 Typical High $3,467.37 | Professional | None | $79.43 | $2,089.30 | $3,467.37 |
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 $2,398.83 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,398.83 | $2,511.89 | $3,311.31 |
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 $1,445.44 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,445.44 | $2,238.72 | $3,715.35 |
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 $645.65 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $645.65 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $257.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $977.24 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $194.98 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $128.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $912.01 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
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 $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
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 |
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 3.7 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 $9,494KY $2,537
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.