How much rates vary
Facilitymedian $1,622 · 10th to 90th $1,023 to $8,318Professionalmedian $1,622 · 10th to 90th $79 to $2,344
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 $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | None | $870.96 | $1,258.93 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,862.09 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $17,378.01 | Facility | None | $1,548.82 | $2,290.87 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,288.25 | $1,949.84 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $1,778.28 | Facility | None | $1,000.00 | $1,584.89 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,290.87 | Facility | None | $1,258.93 | $1,819.70 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $2,454.71 | Professional | None | $79.43 | $1,584.89 | $2,454.71 |
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 $1,698.24 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 $1,047.13 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,047.13 | $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 $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $741.31 | $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 $691.83 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $691.83 | $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 $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
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 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.