How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,445 to $7,413Professionalmedian $2,399 · 10th to 90th $1,230 to $3,715
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $3,801.89 | Facility | None | $1,412.54 | $2,818.38 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,238.72 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,454.71 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $24,547.09 | Facility | None | $1,905.46 | $3,548.13 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,862.09 | $1,949.84 | $3,311.31 |
Pacific Source Setting Facility Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $2,511.89 | Facility | None | $1,445.44 | $2,344.23 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $3,801.89 | Facility | None | $1,412.54 | $2,754.23 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,344.23 Typical High $3,630.78 | Professional | None | $79.43 | $2,344.23 | $3,630.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,964.78 Typical High $12,882.50 | Facility | None | $7,413.10 | $10,964.78 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,715.35 | Professional | None | $2,398.83 | $2,511.89 | $3,715.35 |
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 $1,862.09 Median $2,630.27 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,630.27 | $4,365.16 |
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 $724.44 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $724.44 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $288.40 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,071.52 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $144.54 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $954.99 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,348.96 |
Where Oregon sits
The same service costs 3.2 times more in Alaska than in Delaware. 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
AK $8,931DE $2,772
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.