How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,175 to $12,023Professionalmedian $1,413 · 10th to 90th $832 to $2,291
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 $1,412.54 Median $5,128.61 Typical High $15,848.93 | Facility | None | $1,412.54 | $5,128.61 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,479.11 | Professional | None | $676.08 | $912.01 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $8,912.51 Typical High $12,022.64 | Facility | None | $1,412.54 | $8,912.51 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $2,454.71 | Professional | None | $891.25 | $1,479.11 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,621.81 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $24,547.09 | Facility | None | $1,174.90 | $2,344.23 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $2,089.30 | Professional | None | $776.25 | $1,258.93 | $2,089.30 |
Pacific Source Setting Facility Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $2,041.74 | Facility | None | $1,174.90 | $1,819.70 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $1,202.26 Median $5,248.07 Typical High $11,748.98 | Facility | None | $1,202.26 | $5,248.07 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,445.44 Typical High $2,454.71 | Professional | None | $79.43 | $1,445.44 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $25,118.86 Typical High $28,183.83 | Facility | None | $8,912.51 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,862.09 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,691.53 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,691.53 | $25,118.86 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $2,570.40 | Professional | None | $870.96 | $1,513.56 | $2,570.40 |
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 $416.87 Median $416.87 Typical High $741.31 | Professional | 52 · Reduced service | $416.87 | $416.87 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $295.12 | Professional | 53 · Discontinued | $165.96 | $165.96 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,122.02 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $223.87 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $147.91 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $416.87 Typical High $741.31 | Professional | 52 · Reduced service | $416.87 | $416.87 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $295.12 | Professional | 53 · Discontinued | $165.96 | $165.96 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $1,122.02 | Professional | 54 · Surgery only | $616.60 | $616.60 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $223.87 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $147.91 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $1,047.13 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,489.63 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $13,489.63 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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
AK $10,217WV $2,002
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.