How much rates vary
Facilitymedian $1,000 · 10th to 90th $741 to $8,128Professionalmedian $912 · 10th to 90th $513 to $1,349
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 $8,912.51 Typical High $18,620.87 | Facility | None | $5,128.61 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $707.95 | Professional | None | $489.78 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $4,168.69 | Facility | None | $1,230.27 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,412.54 | Professional | None | $537.03 | $851.14 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,288.25 | Professional | None | $891.25 | $1,047.13 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $18,620.87 | Facility | None | $1,000.00 | $1,348.96 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,202.26 | Professional | None | $707.95 | $776.25 | $1,202.26 |
Pacific Source Setting Facility Modifier None Typical Low $588.84 Median $933.25 Typical High $1,023.29 | Facility | None | $588.84 | $933.25 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,818.38 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $912.01 Typical High $1,380.38 | Professional | None | $79.43 | $912.01 | $1,380.38 |
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 $954.99 Median $1,023.29 Typical High $1,318.26 | Professional | None | $954.99 | $1,023.29 | $1,318.26 |
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 $645.65 Median $891.25 Typical High $1,479.11 | Professional | None | $645.65 | $891.25 | $1,479.11 |
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 $281.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $489.78 |
Where Oregon sits
The same service costs 4.5 times more in Wisconsin 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
WI $7,285MT $1,607
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.