How much rates vary
Facilitymedian $1,349 · 10th to 90th $955 to $10,233Professionalmedian $1,230 · 10th to 90th $646 to $1,905
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 $1,202.26 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,202.26 | $7,943.28 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,202.26 | Professional | None | $645.65 | $977.24 | $1,202.26 |
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 $724.44 Median $1,148.15 Typical High $1,905.46 | Professional | None | $724.44 | $1,148.15 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,412.54 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $6,025.60 Typical High $18,620.87 | Facility | None | $1,202.26 | $6,025.60 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $2,187.76 | Professional | None | $676.08 | $1,047.13 | $2,187.76 |
Pacific Source Setting Facility Modifier None Typical Low $812.83 Median $1,348.96 Typical High $1,380.38 | Facility | None | $812.83 | $1,348.96 | $1,380.38 |
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 $1,288.25 Typical High $1,905.46 | Professional | None | $79.43 | $1,288.25 | $1,905.46 |
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 $1,318.26 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,412.54 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $2,691.53 Typical High $25,118.86 | Facility | None | $1,548.82 | $2,691.53 | $25,118.86 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $2,041.74 | Professional | None | $812.83 | $1,258.93 | $2,041.74 |
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 $398.11 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $158.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
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 3.6 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 $7,904MT $2,218
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.