How much rates vary
Facilitymedian $1,660 · 10th to 90th $1,047 to $4,571Professionalmedian $1,585 · 10th to 90th $813 to $2,239
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,071.52 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,090.30 Typical High $4,168.69 | Facility | None | $870.96 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,318.26 Typical High $2,238.72 | Professional | None | $870.96 | $1,318.26 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,659.59 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,089.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,348.96 | $1,995.26 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $1,698.24 | Facility | None | $1,000.00 | $1,584.89 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,023.29 | $2,754.23 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $2,290.87 | Professional | None | $79.43 | $1,584.89 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $21,379.62 Typical High $29,512.09 | Facility | None | $6,918.31 | $21,379.62 | $29,512.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,698.24 | $2,238.72 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,548.82 | $2,570.40 |
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 $489.78 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Where Oregon sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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 $11,256KY $2,261
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.