How much rates vary
Facilitymedian $1,047 · 10th to 90th $794 to $7,943Professionalmedian $1,000 · 10th to 90th $537 to $1,445
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $758.58 | Professional | None | $524.81 | $758.58 | $758.58 |
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 $588.84 Median $891.25 Typical High $1,479.11 | Professional | None | $588.84 | $891.25 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,380.38 | Professional | None | $954.99 | $1,122.02 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $17,378.01 | Facility | None | $1,023.29 | $1,513.56 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,258.93 | Professional | None | $758.58 | $851.14 | $1,258.93 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,071.52 | Facility | None | $645.65 | $1,047.13 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,000.00 Typical High $1,479.11 | Professional | None | $79.43 | $1,000.00 | $1,479.11 |
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 $1,023.29 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,071.52 | $1,380.38 |
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 $676.08 Median $977.24 Typical High $1,584.89 | Professional | None | $676.08 | $977.24 | $1,584.89 |
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 $302.00 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
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 4.3 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 $7,406MT $1,722
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.