How much rates vary
Facilitymedian $851 · 10th to 90th $589 to $5,623Professionalmedian $813 · 10th to 90th $417 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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | None | $426.58 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,754.23 Typical High $3,801.89 | Facility | None | $891.25 | $2,754.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,202.26 | Professional | None | $588.84 | $794.33 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,047.13 | Professional | None | $741.31 | $851.14 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $1,258.93 Typical High $8,709.64 | Facility | None | $741.31 | $1,258.93 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,230.27 | Professional | None | $660.69 | $676.08 | $1,230.27 |
Pacific Source Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $870.96 | Facility | None | $501.19 | $831.76 | $870.96 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $2,511.89 Typical High $3,801.89 | Facility | None | $741.31 | $2,511.89 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $812.83 Typical High $1,258.93 | Professional | None | $79.43 | $812.83 | $1,258.93 |
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 $812.83 Median $851.14 Typical High $1,288.25 | Professional | None | $812.83 | $851.14 | $1,288.25 |
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 $630.96 Median $954.99 Typical High $1,479.11 | Professional | None | $630.96 | $954.99 | $1,479.11 |
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 $257.04 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $102.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $380.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $51.29 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $354.81 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $467.74 |
Where Oregon sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.