How much rates vary
Facilitymedian $692 · 10th to 90th $263 to $955Professionalmedian $708 · 10th to 90th $389 to $1,096
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 $380.19 Median $537.03 Typical High $776.25 | Professional | None | $380.19 | $537.03 | $776.25 |
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 $416.87 Median $660.69 Typical High $1,122.02 | Professional | None | $416.87 | $660.69 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,258.93 | Professional | None | $851.14 | $1,000.00 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,737.80 Typical High $6,606.93 | Facility | None | $602.56 | $1,737.80 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $933.25 | Professional | None | $524.81 | $575.44 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $776.25 | Facility | None | $436.52 | $707.95 | $776.25 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $331.13 Typical High $1,000.00 | Facility | None | $229.09 | $331.13 | $1,000.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $691.83 Typical High $1,122.02 | Professional | None | $79.43 | $691.83 | $1,122.02 |
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 $758.58 Median $812.83 Typical High $1,047.13 | Professional | None | $758.58 | $812.83 | $1,047.13 |
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 $426.58 Median $676.08 Typical High $1,148.15 | Professional | None | $426.58 | $676.08 | $1,148.15 |
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 $223.87 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
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 6.4 times more in Connecticut than in Texas. 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 $3,322TX $515
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.