How much rates vary
Facilitymedian $1,259 · 10th to 90th $794 to $4,467Professionalmedian $1,202 · 10th to 90th $646 to $1,738
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 $645.65 Median $891.25 Typical High $891.25 | Professional | None | $645.65 | $891.25 | $891.25 |
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 $660.69 Median $1,047.13 Typical High $1,737.80 | Professional | None | $660.69 | $1,047.13 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,318.26 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,584.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,513.56 | Professional | None | $891.25 | $1,023.29 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $758.58 Median $1,258.93 Typical High $1,318.26 | Facility | None | $758.58 | $1,258.93 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $2,754.23 Typical High $3,981.07 | Facility | None | $870.96 | $2,754.23 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,230.27 Typical High $1,778.28 | Professional | None | $79.43 | $1,230.27 | $1,778.28 |
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 $1,230.27 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,318.26 | $1,698.24 |
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 $794.33 Median $1,202.26 Typical High $1,949.84 | Professional | None | $794.33 | $1,202.26 | $1,949.84 |
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 $371.54 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
Where Oregon sits
The same service costs 7.6 times more in Oklahoma 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
OK $11,248TX $1,472
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.