How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,230 to $9,772Professionalmedian $2,042 · 10th to 90th $1,047 to $3,162
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,258.93 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,905.46 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,995.26 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,737.80 Median $3,019.95 Typical High $18,620.87 | Facility | None | $1,737.80 | $3,019.95 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,621.81 | $2,818.38 |
Pacific Source Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,137.96 | Facility | None | $1,230.27 | $1,995.26 | $2,137.96 |
Providence Setting Facility Modifier None Typical Low $1,348.96 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,348.96 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,041.74 Typical High $3,090.30 | Professional | None | $79.43 | $2,041.74 | $3,090.30 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $3,235.94 | Professional | None | $2,041.74 | $2,137.96 | $3,235.94 |
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 $1,584.89 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,584.89 | $2,238.72 | $3,715.35 |
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 $630.96 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $630.96 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $251.19 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $933.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $125.89 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $870.96 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,096.48 |
Where Oregon sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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 $11,283KY $2,440
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.