How much rates vary
Facilitymedian $1,230 · 10th to 90th $832 to $20,417Professionalmedian $1,122 · 10th to 90th $617 to $1,698
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $870.96 | Professional | None | $562.34 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $17,782.79 Typical High $24,547.09 | Facility | None | $1,230.27 | $17,782.79 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,698.24 | Professional | None | $645.65 | $1,023.29 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,288.25 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $18,620.87 | Facility | None | $1,023.29 | $1,698.24 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,445.44 | Professional | None | $870.96 | $977.24 | $1,445.44 |
Pacific Source Setting Facility Modifier None Typical Low $707.95 Median $1,174.90 Typical High $1,230.27 | Facility | None | $707.95 | $1,174.90 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $16,218.10 Typical High $24,547.09 | Facility | None | $1,047.13 | $16,218.10 | $24,547.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,698.24 | Professional | None | $79.43 | $1,122.02 | $1,698.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $33,884.42 Median $44,668.36 Typical High $56,234.13 | Facility | None | $33,884.42 | $44,668.36 | $56,234.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,258.93 | $1,621.81 |
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 $776.25 Median $1,096.48 Typical High $1,819.70 | Professional | None | $776.25 | $1,096.48 | $1,819.70 |
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 $354.81 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $51,286.14 Median $67,608.30 Typical High $85,113.80 | Facility | 50 · Both sides | $51,286.14 | $67,608.30 | $85,113.80 |
Where Oregon sits
The same service costs 10.1 times more in Alaska than in Montana. 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 $19,890MT $1,977
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.