How much rates vary
Facilitymedian $1,202 · 10th to 90th $794 to $8,128Professionalmedian $1,122 · 10th to 90th $603 to $1,622
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 $776.25 Median $870.96 Typical High $870.96 | Professional | None | $776.25 | $870.96 | $870.96 |
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 $645.65 Median $1,000.00 Typical High $1,659.59 | Professional | None | $645.65 | $1,000.00 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,202.26 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $17,378.01 | Facility | None | $1,047.13 | $1,778.28 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,445.44 | Professional | None | $870.96 | $954.99 | $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 $1,000.00 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,659.59 | Professional | None | $79.43 | $1,122.02 | $1,659.59 |
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 $1,148.15 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,202.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,819.70 | Professional | None | $776.25 | $1,122.02 | $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 $338.84 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $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 $12,302.69 Median $16,982.44 Typical High $19,498.45 | Facility | 50 · Both sides | $12,302.69 | $16,982.44 | $19,498.45 |
Where Oregon sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.