How much rates vary
Facilitymedian $1,738 · 10th to 90th $1,047 to $7,943Professionalmedian $1,660 · 10th to 90th $955 to $2,570
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 $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,318.26 | $1,318.26 |
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 $977.24 Median $1,548.82 Typical High $2,630.27 | Professional | None | $977.24 | $1,548.82 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,698.24 | $1,995.26 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $17,378.01 | Facility | None | $1,479.11 | $2,398.83 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,412.54 | $2,137.96 |
Pacific Source Setting Facility Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $1,905.46 | Facility | None | $1,047.13 | $1,659.59 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,047.13 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,621.81 Typical High $2,570.40 | Professional | None | $79.43 | $1,621.81 | $2,570.40 |
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 $1,778.28 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,905.46 | $2,454.71 |
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 $1,071.52 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,584.89 | $2,691.53 |
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 $537.03 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $213.80 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $794.33 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $741.31 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $933.25 |
Where Oregon sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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 $8,167HI $2,648
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.