How much rates vary
Facilitymedian $933 · 10th to 90th $676 to $8,710Professionalmedian $851 · 10th to 90th $479 to $1,288
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 $812.83 Median $5,623.41 Typical High $8,709.64 | Facility | None | $812.83 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $724.44 | Professional | None | $457.09 | $660.69 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $6,918.31 Typical High $9,549.93 | Facility | None | $891.25 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,318.26 | Professional | None | $512.86 | $794.33 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,202.26 | Professional | None | $851.14 | $1,000.00 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $2,818.38 Typical High $8,709.64 | Facility | None | $812.83 | $2,818.38 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,122.02 | Professional | None | $501.19 | $724.44 | $1,122.02 |
Pacific Source Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $954.99 | Facility | None | $549.54 | $912.01 | $954.99 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $6,309.57 Typical High $9,549.93 | Facility | None | $870.96 | $6,309.57 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,318.26 | Professional | None | $79.43 | $870.96 | $1,318.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,230.27 | Professional | None | $912.01 | $954.99 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,412.54 | Professional | None | $616.60 | $851.14 | $1,412.54 |
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 $269.15 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $269.15 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $53.70 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $467.74 |
Where Oregon sits
The same service costs 7.0 times more in Alabama than in Montana. 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
AL $10,808MT $1,535
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.