How much rates vary
Facilitymedian $1,230 · 10th to 90th $741 to $6,918Professionalmedian $1,148 · 10th to 90th $646 to $1,820
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 $616.60 Median $977.24 Typical High $977.24 | Professional | None | $616.60 | $977.24 | $977.24 |
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 $724.44 Median $1,122.02 Typical High $1,905.46 | Professional | None | $724.44 | $1,122.02 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,445.44 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $17,378.01 | Facility | None | $1,122.02 | $1,698.24 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,548.82 | Professional | None | $707.95 | $977.24 | $1,548.82 |
Pacific Source Setting Facility Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,348.96 | Facility | None | $741.31 | $1,174.90 | $1,348.96 |
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 $1,148.15 Typical High $1,862.09 | Professional | None | $79.43 | $1,148.15 | $1,862.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $11,220.18 Typical High $12,882.50 | Facility | None | $4,570.88 | $11,220.18 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,348.96 | $1,778.28 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,949.84 | Professional | None | $776.25 | $1,148.15 | $1,949.84 |
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 $380.19 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
Where Oregon sits
The same service costs 4.3 times more in Alaska than in West Virginia. 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 $6,645WV $1,559
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.