How much rates vary
Facilitymedian $1,698 · 10th to 90th $1,023 to $19,953Professionalmedian $1,585 · 10th to 90th $871 to $2,399
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 $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $16,595.87 Typical High $22,908.68 | Facility | None | $1,000.00 | $16,595.87 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $2,398.83 | Professional | None | $912.01 | $1,445.44 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,778.28 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $17,378.01 | Facility | None | $1,348.96 | $2,344.23 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,348.96 | $2,041.74 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $1,737.80 | Facility | None | $1,000.00 | $1,621.81 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $15,135.61 Typical High $21,379.62 | Facility | None | $1,047.13 | $15,135.61 | $21,379.62 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $2,398.83 | Professional | None | $79.43 | $1,584.89 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $33,884.42 Median $44,668.36 Typical High $56,234.13 | Facility | None | $33,884.42 | $44,668.36 | $56,234.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,778.28 | $2,290.87 |
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 $1,047.13 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,584.89 | $2,570.40 |
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 $501.19 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $51,286.14 Median $67,608.30 Typical High $85,113.80 | Facility | 50 · Both sides | $51,286.14 | $67,608.30 | $85,113.80 |
Where Oregon sits
The same service costs 7.5 times more in Alaska than in Hawaii. 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 $19,036HI $2,542
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.