How much rates vary
Facilitymedian $1,660 · 10th to 90th $1,023 to $12,023Professionalmedian $1,549 · 10th to 90th $891 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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $8,709.64 Typical High $12,022.64 | Facility | None | $1,230.27 | $8,709.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,454.71 | Professional | None | $933.25 | $1,479.11 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,621.81 | $1,905.46 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $18,620.87 | Facility | None | $1,445.44 | $2,238.72 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,380.38 | $2,041.74 |
Pacific Source Setting Facility Modifier None Typical Low $977.24 Median $1,584.89 Typical High $1,778.28 | Facility | None | $977.24 | $1,584.89 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $7,943.28 Typical High $12,022.64 | Facility | None | $1,288.25 | $7,943.28 | $12,022.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,548.82 Typical High $2,454.71 | Professional | None | $79.43 | $1,548.82 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,778.28 | $2,344.23 |
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 $1,023.29 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,513.56 | $2,511.89 |
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 $501.19 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $199.53 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $758.58 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $151.36 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $100.00 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $707.95 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $954.99 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $891.25 |
Where Oregon sits
The same service costs 4.5 times more in Alaska 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
AK $12,963MT $2,892
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.