How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,349 to $11,482Professionalmedian $2,089 · 10th to 90th $1,148 to $3,090
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 $1,949.84 Median $10,232.93 Typical High $24,547.09 | Facility | None | $1,949.84 | $10,232.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $9,332.54 Typical High $12,589.25 | Facility | None | $870.96 | $9,332.54 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,862.09 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,290.87 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,090.30 Typical High $19,952.62 | Facility | None | $1,949.84 | $3,090.30 | $19,952.62 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,737.80 | $2,570.40 |
Pacific Source Setting Facility Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $2,290.87 | Facility | None | $1,318.26 | $2,137.96 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $8,317.64 Typical High $12,022.64 | Facility | None | $1,023.29 | $8,317.64 | $12,022.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,089.30 Typical High $3,090.30 | Professional | None | $79.43 | $2,089.30 | $3,090.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $21,379.62 Typical High $29,512.09 | Facility | None | $6,918.31 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,290.87 | $2,951.21 |
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 $1,348.96 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,041.74 | $3,311.31 |
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 $645.65 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,096.48 |
Where Oregon sits
The same service costs 5.1 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 $14,343KY $2,808
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.