How much rates vary
Facilitymedian $562 · 10th to 90th $257 to $724Professionalmedian $550 · 10th to 90th $355 to $851
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 $524.81 Median $5,128.61 Typical High $7,943.28 | Facility | None | $524.81 | $5,128.61 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $457.09 | Professional | None | $288.40 | $389.05 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $371.54 | Facility | None | $147.91 | $263.03 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $891.25 | Professional | None | $363.08 | $524.81 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $954.99 | Professional | None | $602.56 | $758.58 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $645.65 Typical High $7,943.28 | Facility | None | $436.52 | $645.65 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $707.95 | Professional | None | $389.05 | $457.09 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $660.69 | Facility | None | $363.08 | $588.84 | $660.69 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $758.58 | Facility | None | $218.78 | $323.59 | $758.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $549.54 Typical High $870.96 | Professional | None | $79.43 | $549.54 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $954.99 | Facility | None | $645.65 | $812.83 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $794.33 | Professional | None | $549.54 | $630.96 | $794.33 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $912.01 | Professional | None | $363.08 | $537.03 | $912.01 |
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 $181.97 Median $194.98 Typical High $229.09 | Professional | 52 · Reduced service | $181.97 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $72.44 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $45.71 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 52 · Reduced service | $194.98 | $194.98 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $79.43 | $93.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $295.12 | $346.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $45.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $323.59 |
Where Oregon sits
The same service costs 6.7 times more in New York than in Florida. 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
NY $2,828FL $419
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.