How much rates vary
Facilitymedian $1,479 · 10th to 90th $871 to $4,677Professionalmedian $1,380 · 10th to 90th $741 to $2,042
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 $3,890.45 Median $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,202.26 | Professional | None | $707.95 | $1,047.13 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,238.72 | Facility | None | $891.25 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,089.30 | Professional | None | $794.33 | $1,230.27 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,659.59 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,137.96 Typical High $8,709.64 | Facility | None | $1,047.13 | $2,137.96 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,737.80 | Professional | None | $954.99 | $1,202.26 | $1,737.80 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,513.56 | Facility | None | $891.25 | $1,412.54 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,238.72 | Facility | None | $891.25 | $1,621.81 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,412.54 Typical High $2,089.30 | Professional | None | $79.43 | $1,412.54 | $2,089.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,309.57 | Facility | None | $4,073.80 | $5,623.41 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,548.82 | $1,995.26 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $2,238.72 | Professional | None | $954.99 | $1,380.38 | $2,238.72 |
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 $436.52 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,025.60 Median $8,317.64 Typical High $9,549.93 | Facility | 50 · Both sides | $6,025.60 | $8,317.64 | $9,549.93 |
Where Oregon sits
The same service costs 3.6 times more in Alaska than in Alabama. 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 $5,545AL $1,558
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.