How much rates vary
Facilitymedian $1,122 · 10th to 90th $776 to $8,128Professionalmedian $1,047 · 10th to 90th $575 to $1,549
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 $724.44 Median $794.33 Typical High $794.33 | Professional | None | $724.44 | $794.33 | $794.33 |
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 $602.56 Median $954.99 Typical High $1,584.89 | Professional | None | $602.56 | $954.99 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,174.90 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $17,378.01 | Facility | None | $1,122.02 | $1,513.56 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,348.96 | Professional | None | $794.33 | $891.25 | $1,348.96 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,148.15 | Facility | None | $660.69 | $1,047.13 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,047.13 Typical High $1,584.89 | Professional | None | $79.43 | $1,047.13 | $1,584.89 |
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 $1,096.48 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,148.15 | $1,479.11 |
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 $741.31 Median $1,000.00 Typical High $1,659.59 | Professional | None | $741.31 | $1,000.00 | $1,659.59 |
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 $323.59 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $323.59 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $549.54 |
Where Oregon sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.