How much rates vary
Facilitymedian $955 · 10th to 90th $661 to $9,550Professionalmedian $851 · 10th to 90th $468 to $1,318
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 $831.76 Median $12,302.69 Typical High $33,884.42 | Facility | None | $831.76 | $12,302.69 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $776.25 | Professional | None | $436.52 | $676.08 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $4,168.69 | Facility | None | $1,819.70 | $3,162.28 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $1,348.96 | Professional | None | $512.86 | $812.83 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,258.93 | Professional | None | $870.96 | $1,023.29 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $7,943.28 Typical High $19,054.61 | Facility | None | $812.83 | $7,943.28 | $19,054.61 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,288.25 | Professional | None | $489.78 | $758.58 | $1,288.25 |
Pacific Source Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $954.99 | Facility | None | $549.54 | $891.25 | $954.99 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $4,466.84 | Facility | None | $954.99 | $2,818.38 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,348.96 | Professional | None | $79.43 | $870.96 | $1,348.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,220.18 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,220.18 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,258.93 | Professional | None | $933.25 | $977.24 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,412.54 | Professional | None | $549.54 | $851.14 | $1,412.54 |
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 $275.42 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $407.38 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $478.63 |
Where Oregon sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.