How much rates vary
Facilitymedian $3,388 · 10th to 90th $2,042 to $27,542Professionalmedian $3,162 · 10th to 90th $1,622 to $4,677
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 $3,019.95 Median $11,748.98 Typical High $33,884.42 | Facility | None | $3,019.95 | $11,748.98 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,621.81 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $26,302.68 Typical High $35,481.34 | Facility | None | $870.96 | $26,302.68 | $35,481.34 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $4,786.30 | Professional | None | $1,819.70 | $2,884.03 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $4,168.69 | Professional | None | $2,951.21 | $3,467.37 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $3,019.95 Median $7,943.28 Typical High $33,884.42 | Facility | None | $3,019.95 | $7,943.28 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,630.27 Typical High $4,073.80 | Professional | None | $1,778.28 | $2,630.27 | $4,073.80 |
Pacific Source Setting Facility Modifier None Typical Low $2,041.74 Median $3,311.31 Typical High $3,548.13 | Facility | None | $2,041.74 | $3,311.31 | $3,548.13 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $23,442.29 Typical High $33,884.42 | Facility | None | $1,023.29 | $23,442.29 | $33,884.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,235.94 Typical High $4,786.30 | Professional | None | $79.43 | $3,235.94 | $4,786.30 |
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 $3,388.44 Median $3,548.13 Typical High $4,570.88 | Professional | None | $3,388.44 | $3,548.13 | $4,570.88 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $7,244.36 Typical High $50,118.72 | Facility | None | $2,951.21 | $7,244.36 | $50,118.72 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,235.94 Typical High $5,248.07 | Professional | None | $2,137.96 | $3,235.94 | $5,248.07 |
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 $1,000.00 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,000.00 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $398.11 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,513.56 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,698.24 | $1,698.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,698.24 |
Where Oregon sits
The same service costs 7.8 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 $30,522KY $3,909
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.