How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,148 to $17,378Professionalmedian $1,738 · 10th to 90th $891 to $2,692
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 $1,698.24 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,698.24 | $7,943.28 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $1,698.24 | Professional | None | $891.25 | $1,380.38 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $8,912.51 Typical High $12,302.69 | Facility | None | $1,000.00 | $8,912.51 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,621.81 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,949.84 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $6,025.60 Typical High $32,359.37 | Facility | None | $1,949.84 | $6,025.60 | $32,359.37 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $3,162.28 | Professional | None | $891.25 | $1,479.11 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $1,949.84 | Facility | None | $1,148.15 | $1,905.46 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $8,128.31 Typical High $12,302.69 | Facility | None | $1,047.13 | $8,128.31 | $12,302.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,819.70 Typical High $2,691.53 | Professional | None | $79.43 | $1,819.70 | $2,691.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,995.26 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,495.41 Typical High $25,118.86 | Facility | None | $2,691.53 | $5,495.41 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,778.28 | $2,884.03 |
14 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 $562.34 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $346.74 Typical High $537.03 | Professional | AS · PA/NP assist | $239.88 | $346.74 | $537.03 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $26,915.35 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $26,915.35 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 5.9 times more in Vermont than in Hawaii. 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
VT $17,840HI $3,009
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.