How much rates vary
Facilitymedian $575 · 10th to 90th $269 to $813Professionalmedian $550 · 10th to 90th $339 to $851
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $501.19 | Professional | None | $288.40 | $407.38 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $660.69 | Facility | None | $223.87 | $281.84 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $870.96 | Professional | None | $346.74 | $512.86 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $891.25 | Professional | None | $588.84 | $741.31 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $6,606.93 | Facility | None | $446.68 | $741.31 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $691.83 | Professional | None | $331.13 | $446.68 | $691.83 |
Pacific Source Setting Facility Modifier None Typical Low $354.81 Median $588.84 Typical High $630.96 | Facility | None | $354.81 | $588.84 | $630.96 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $794.33 | Facility | None | $229.09 | $436.52 | $794.33 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $870.96 | Professional | None | $79.43 | $562.34 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $954.99 | Facility | None | $645.65 | $812.83 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $794.33 | Professional | None | $562.34 | $616.60 | $794.33 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $933.25 | Professional | None | $346.74 | $537.03 | $933.25 |
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 $177.83 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $72.44 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $288.40 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $251.19 | $288.40 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $204.17 | $204.17 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $81.28 | $81.28 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $309.03 | $309.03 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $44.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $316.23 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Facility | 50 · Both sides | $954.99 | $1,230.27 | $1,445.44 |
Where Oregon sits
The same service costs 6.5 times more in Connecticut than in Maryland. 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
CT $3,149MD $483
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.