How much rates vary
Facilitymedian $851 · 10th to 90th $603 to $7,943Professionalmedian $776 · 10th to 90th $437 to $1,148
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 $8,317.64 Typical High $17,378.01 | Facility | None | $5,128.61 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $676.08 | Professional | None | $398.11 | $588.84 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $4,168.69 | Facility | None | $1,000.00 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,174.90 | Professional | None | $457.09 | $707.95 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,122.02 | Professional | None | $776.25 | $912.01 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,174.90 Typical High $17,378.01 | Facility | None | $691.83 | $1,174.90 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $977.24 | Professional | None | $467.74 | $676.08 | $977.24 |
Pacific Source Setting Facility Modifier None Typical Low $489.78 Median $812.83 Typical High $851.14 | Facility | None | $489.78 | $812.83 | $851.14 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $2,754.23 Typical High $4,168.69 | Facility | None | $831.76 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $776.25 Typical High $1,174.90 | Professional | None | $79.43 | $776.25 | $1,174.90 |
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 $812.83 Median $851.14 Typical High $1,096.48 | Professional | None | $812.83 | $851.14 | $1,096.48 |
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 $524.81 Median $776.25 Typical High $1,258.93 | Professional | None | $524.81 | $776.25 | $1,258.93 |
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 $239.88 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $47.86 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $338.84 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $446.68 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $416.87 |
Where Oregon sits
The same service costs 5.1 times more in Wisconsin 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
WI $7,097MT $1,384
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.