How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,318 to $6,918Professionalmedian $2,512 · 10th to 90th $1,413 to $3,802
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 $1,698.24 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,698.24 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,000.00 | $2,398.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,479.11 | $2,344.23 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,398.83 | $2,818.38 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $1,862.09 Median $3,715.35 Typical High $17,378.01 | Facility | None | $1,862.09 | $3,715.35 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,659.59 | $1,862.09 | $3,090.30 |
Pacific Source Setting Facility Modifier None Typical Low $1,548.82 Median $2,570.40 Typical High $2,754.23 | Facility | None | $1,548.82 | $2,570.40 | $2,754.23 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $2,511.89 Typical High $3,467.37 | Facility | None | $1,047.13 | $2,511.89 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,454.71 Typical High $3,890.45 | Professional | None | $79.43 | $2,454.71 | $3,890.45 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $9,772.37 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,754.23 | $2,884.03 | $3,548.13 |
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 $1,548.82 Median $2,454.71 Typical High $4,168.69 | Professional | None | $1,548.82 | $2,454.71 | $4,168.69 |
13 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 $758.58 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $758.58 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $10,471.29 Median $14,791.08 Typical High $16,982.44 | Facility | 50 · Both sides | $10,471.29 | $14,791.08 | $16,982.44 |
Where Oregon sits
The same service costs 3.7 times more in Alaska than in Delaware. 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 $8,917DE $2,410
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.