How much rates vary
Facilitymedian $1,585 · 10th to 90th $1,096 to $8,913Professionalmedian $1,445 · 10th to 90th $813 to $2,239
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,148.15 | Professional | None | $741.31 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $4,168.69 | Facility | None | $1,230.27 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $2,238.72 | Professional | None | $851.14 | $1,348.96 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,659.59 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $18,620.87 | Facility | None | $1,258.93 | $2,238.72 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,230.27 | $1,819.70 |
Pacific Source Setting Facility Modifier None Typical Low $933.25 Median $1,548.82 Typical High $1,621.81 | Facility | None | $933.25 | $1,548.82 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $1,148.15 Median $2,818.38 Typical High $4,168.69 | Facility | None | $1,148.15 | $2,818.38 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,479.11 Typical High $2,238.72 | Professional | None | $79.43 | $1,479.11 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,481.54 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,481.54 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,659.59 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,398.83 | Professional | None | $933.25 | $1,445.44 | $2,398.83 |
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 $467.74 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $16,982.44 Typical High $19,498.45 | Facility | 50 · Both sides | $12,302.69 | $16,982.44 | $19,498.45 |
Where Oregon sits
The same service costs 3.1 times more in Wisconsin than in Maryland. 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
WI $8,115MD $2,591
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.