How much rates vary
Facilitymedian $912 · 10th to 90th $631 to $7,943Professionalmedian $832 · 10th to 90th $457 to $1,259
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 $416.87 Median $645.65 Typical High $645.65 | Professional | None | $416.87 | $645.65 | $645.65 |
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 $489.78 Median $776.25 Typical High $1,288.25 | Professional | None | $489.78 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,202.26 | Professional | None | $831.76 | $977.24 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,258.93 Typical High $17,378.01 | Facility | None | $707.95 | $1,258.93 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,096.48 | Professional | None | $645.65 | $724.44 | $1,096.48 |
Pacific Source Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $912.01 | Facility | None | $524.81 | $851.14 | $912.01 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $2,754.23 Typical High $4,168.69 | Facility | None | $831.76 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $831.76 Typical High $1,258.93 | Professional | None | $79.43 | $831.76 | $1,258.93 |
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 $870.96 Median $933.25 Typical High $1,202.26 | Professional | None | $870.96 | $933.25 | $1,202.26 |
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 $524.81 Median $812.83 Typical High $1,348.96 | Professional | None | $524.81 | $812.83 | $1,348.96 |
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 $257.04 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $52.48 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $363.08 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
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 4.9 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 $7,341MT $1,483
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.