How much rates vary
Facilitymedian $3,981 · 10th to 90th $2,344 to $8,913Professionalmedian $3,715 · 10th to 90th $1,778 to $5,495
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,570.40 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $6,918.31 Typical High $9,549.93 | Facility | None | $870.96 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $3,311.31 Typical High $5,623.41 | Professional | None | $2,089.30 | $3,311.31 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,467.37 Median $3,981.07 Typical High $4,897.79 | Professional | None | $3,467.37 | $3,981.07 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $2,884.03 Median $5,623.41 Typical High $24,547.09 | Facility | None | $2,884.03 | $5,623.41 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $4,570.88 | Professional | None | $1,819.70 | $2,884.03 | $4,570.88 |
Pacific Source Setting Facility Modifier None Typical Low $2,344.23 Median $3,981.07 Typical High $4,168.69 | Facility | None | $2,344.23 | $3,981.07 | $4,168.69 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $6,165.95 Typical High $8,912.51 | Facility | None | $1,023.29 | $6,165.95 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,715.35 Typical High $5,623.41 | Professional | None | $79.43 | $3,715.35 | $5,623.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,489.63 Median $41,686.94 Typical High $57,543.99 | Facility | None | $13,489.63 | $41,686.94 | $57,543.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,890.45 Median $4,168.69 Typical High $5,370.32 | Professional | None | $3,890.45 | $4,168.69 | $5,370.32 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,715.35 Typical High $6,165.95 | Professional | None | $2,344.23 | $3,715.35 | $6,165.95 |
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 $1,174.90 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,174.90 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,737.80 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,995.26 | $1,995.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $575.44 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $1,995.26 |
Where Oregon sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.