How much rates vary
Facilitymedian $1,549 · 10th to 90th $933 to $6,166Professionalmedian $1,445 · 10th to 90th $759 to $2,089
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,071.52 | Professional | None | $812.83 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,090.30 Typical High $4,168.69 | Facility | None | $870.96 | $3,090.30 | $4,168.69 |
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 $1,318.26 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,548.82 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $7,943.28 | Facility | None | $1,174.90 | $1,905.46 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,778.28 | Professional | None | $851.14 | $1,202.26 | $1,778.28 |
Pacific Source Setting Facility Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,584.89 | Facility | None | $933.25 | $1,479.11 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,023.29 | $2,754.23 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,479.11 Typical High $2,137.96 | Professional | None | $79.43 | $1,479.11 | $2,137.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,378.01 Median $53,703.18 Typical High $74,131.02 | Facility | None | $17,378.01 | $53,703.18 | $74,131.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,584.89 | $2,041.74 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $6,918.31 Typical High $48,977.88 | Facility | None | $2,951.21 | $6,918.31 | $48,977.88 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,344.23 | Professional | None | $977.24 | $1,445.44 | $2,344.23 |
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 $446.68 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Oregon sits
The same service costs 4.3 times more in Alaska than in Texas. 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 $9,769TX $2,271
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.