How much rates vary
Facilitymedian $1,288 · 10th to 90th $871 to $5,623Professionalmedian $1,202 · 10th to 90th $631 to $1,778
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 $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $933.25 | Professional | None | $616.60 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $4,168.69 | Facility | None | $891.25 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,096.48 Typical High $1,819.70 | Professional | None | $707.95 | $1,096.48 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,348.96 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $8,709.64 | Facility | None | $1,096.48 | $1,819.70 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,698.24 | Professional | None | $691.83 | $1,000.00 | $1,698.24 |
Pacific Source Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,318.26 | Facility | None | $776.25 | $1,258.93 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $2,754.23 Typical High $4,168.69 | Facility | None | $891.25 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,230.27 Typical High $1,819.70 | Professional | None | $79.43 | $1,230.27 | $1,819.70 |
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 $1,258.93 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,318.26 | $1,737.80 |
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 $851.14 Median $1,202.26 Typical High $1,949.84 | Professional | None | $851.14 | $1,202.26 | $1,949.84 |
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 $371.54 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $371.54 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $562.34 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $112.20 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $524.81 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $186.21 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
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 3.5 times more in Wisconsin than in Hawaii. 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 $7,283HI $2,091
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.