How much rates vary
Facilitymedian $871 · 10th to 90th $676 to $7,943Professionalmedian $813 · 10th to 90th $457 to $1,230
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 $8,317.64 Typical High $17,378.01 | Facility | None | $5,128.61 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | None | $446.68 | $616.60 | $616.60 |
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 $467.74 Median $741.31 Typical High $1,230.27 | Professional | None | $467.74 | $741.31 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,122.02 | Professional | None | $794.33 | $912.01 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,202.26 Typical High $17,378.01 | Facility | None | $891.25 | $1,202.26 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,071.52 | Professional | None | $524.81 | $691.83 | $1,071.52 |
Pacific Source Setting Facility Modifier None Typical Low $588.84 Median $831.76 Typical High $891.25 | Facility | None | $588.84 | $831.76 | $891.25 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $2,754.23 Typical High $4,168.69 | Facility | None | $891.25 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $812.83 Typical High $1,230.27 | Professional | None | $79.43 | $812.83 | $1,230.27 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,220.18 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,220.18 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,174.90 | Professional | None | $851.14 | $891.25 | $1,174.90 |
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 $575.44 Median $794.33 Typical High $1,288.25 | Professional | None | $575.44 | $794.33 | $1,288.25 |
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 $251.19 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $50.12 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $467.74 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $436.52 |
Where Oregon sits
The same service costs 5.0 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 $7,200MT $1,432
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.