How much rates vary
Facilitymedian $1,380 · 10th to 90th $977 to $8,913Professionalmedian $1,349 · 10th to 90th $79 to $1,950
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 $758.58 Median $1,000.00 Typical High $1,000.00 | Professional | None | $758.58 | $1,000.00 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,479.11 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $18,620.87 | Facility | None | $1,445.44 | $1,737.80 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $933.25 | $1,071.52 | $1,621.81 |
Pacific Source Setting Facility Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,479.11 | Facility | None | $831.76 | $1,380.38 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $1,548.82 Typical High $1,995.26 | Facility | None | $977.24 | $1,548.82 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,348.96 Typical High $1,995.26 | Professional | None | $79.43 | $1,348.96 | $1,995.26 |
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 $1,380.38 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,479.11 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,137.96 | Professional | None | $954.99 | $1,288.25 | $2,137.96 |
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 $416.87 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Where Oregon sits
The same service costs 4.4 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 $9,724MT $2,195
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.