How much rates vary
Facilitymedian $1,096 · 10th to 90th $661 to $7,943Professionalmedian $832 · 10th to 90th $575 to $1,380
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $831.76 | Professional | None | $524.81 | $575.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $4,168.69 | Facility | None | $1,000.00 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,412.54 | Professional | None | $575.44 | $831.76 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,445.44 | Professional | None | $776.25 | $1,071.52 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $1,202.26 Typical High $13,182.57 | Facility | None | $812.83 | $1,202.26 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,202.26 | Professional | None | $575.44 | $831.76 | $1,202.26 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,148.15 | Facility | None | $660.69 | $1,047.13 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $2,511.89 Typical High $4,168.69 | Facility | None | $831.76 | $2,511.89 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,412.54 | Professional | None | $79.43 | $870.96 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,481.54 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,481.54 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,174.90 | Professional | None | $794.33 | $1,096.48 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,513.56 | Professional | None | $588.84 | $912.01 | $1,513.56 |
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 $288.40 Median $288.40 Typical High $416.87 | Professional | 52 · Reduced service | $288.40 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | 53 · Discontinued | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $630.96 | Professional | 54 · Surgery only | $426.58 | $426.58 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $125.89 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $416.87 | Professional | 52 · Reduced service | $288.40 | $288.40 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | 53 · Discontinued | $114.82 | $114.82 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $630.96 | Professional | 54 · Surgery only | $426.58 | $426.58 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $125.89 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $588.84 |
Where Oregon sits
The same service costs 5.8 times more in Alabama 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
AL $8,423MT $1,458
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.