How much rates vary
Facilitymedian $933 · 10th to 90th $661 to $7,943Professionalmedian $851 · 10th to 90th $490 to $1,318
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 $512.86 Median $676.08 Typical High $676.08 | Professional | None | $512.86 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $4,168.69 | Facility | None | $1,000.00 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,348.96 | Professional | None | $501.19 | $794.33 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,202.26 | Professional | None | $831.76 | $977.24 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,318.26 Typical High $17,378.01 | Facility | None | $741.31 | $1,318.26 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,122.02 | Professional | None | $676.08 | $724.44 | $1,122.02 |
Pacific Source Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $977.24 | Facility | None | $549.54 | $891.25 | $977.24 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $2,754.23 Typical High $4,168.69 | Facility | None | $831.76 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,348.96 | Professional | None | $79.43 | $870.96 | $1,348.96 |
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 $933.25 Median $977.24 Typical High $1,258.93 | Professional | None | $933.25 | $977.24 | $1,258.93 |
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 $562.34 Median $851.14 Typical High $1,412.54 | Professional | None | $562.34 | $851.14 | $1,412.54 |
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 $275.42 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $467.74 |
Where Oregon sits
The same service costs 4.6 times more in Alabama 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
AL $7,006MT $1,517
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.