How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,905 to $11,220Professionalmedian $3,020 · 10th to 90th $1,622 to $4,467
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 $1,479.11 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,479.11 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $9,120.11 Typical High $12,589.25 | Facility | None | $870.96 | $9,120.11 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $4,466.84 | Professional | None | $1,698.24 | $2,691.53 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,818.38 | $3,235.94 | $3,981.07 |
Moda Health Setting Facility Modifier None Typical Low $2,511.89 Median $4,570.88 Typical High $24,547.09 | Facility | None | $2,511.89 | $4,570.88 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $3,715.35 | Professional | None | $2,238.72 | $2,454.71 | $3,715.35 |
Pacific Source Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $3,311.31 | Facility | None | $1,905.46 | $3,019.95 | $3,311.31 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $8,317.64 Typical High $11,748.98 | Facility | None | $1,023.29 | $8,317.64 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,090.30 Typical High $4,570.88 | Professional | None | $79.43 | $3,090.30 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,511.38 Median $21,379.62 Typical High $29,512.09 | Facility | None | $8,511.38 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,162.28 Median $3,311.31 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,311.31 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $4,897.79 | Professional | None | $1,995.26 | $3,019.95 | $4,897.79 |
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $933.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $380.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,412.54 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,621.81 |
Where Oregon sits
The same service costs 4.7 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 $16,761KY $3,604
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.