How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,884 to $9,772Professionalmedian $9,120 · 10th to 90th $79 to $13,804
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $5,754.40 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,754.40 | $6,918.31 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8,128.31 Median $9,549.93 Typical High $11,220.18 | Professional | None | $8,128.31 | $9,549.93 | $11,220.18 |
Moda Health Setting Facility Modifier None Typical Low $6,918.31 Median $7,943.28 Typical High $13,489.63 | Facility | None | $6,918.31 | $7,943.28 | $13,489.63 |
Moda Health Setting Professional Modifier None Typical Low $6,025.60 Median $7,413.10 Typical High $12,882.50 | Professional | None | $6,025.60 | $7,413.10 | $12,882.50 |
Pacific Source Setting Facility Modifier None Typical Low $5,495.41 Median $8,511.38 Typical High $9,549.93 | Facility | None | $5,495.41 | $8,511.38 | $9,549.93 |
Providence Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $13,489.63 | Facility | None | $6,309.57 | $10,000.00 | $13,489.63 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $9,120.11 Typical High $13,803.84 | Professional | None | $79.43 | $9,120.11 | $13,803.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $25,118.86 Median $25,118.86 Typical High $25,118.86 | Facility | None | $25,118.86 | $25,118.86 | $25,118.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $9,120.11 Median $9,549.93 Typical High $14,125.38 | Professional | None | $9,120.11 | $9,549.93 | $14,125.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $7,244.36 Median $10,471.29 Typical High $16,595.87 | Professional | None | $7,244.36 | $10,471.29 | $16,595.87 |
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 $2,884.03 Median $3,467.37 Typical High $3,467.37 | Professional | 52 · Reduced service | $2,884.03 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $1,148.15 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,265.80 Median $5,248.07 Typical High $5,248.07 | Professional | 54 · Surgery only | $4,265.80 | $5,248.07 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $851.14 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,981.07 Median $4,897.79 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $3,981.07 | $4,897.79 | $4,897.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | 52 · Reduced service | $3,467.37 | $3,467.37 | $3,467.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $1,380.38 | $1,380.38 | $1,380.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | 54 · Surgery only | $5,248.07 | $5,248.07 | $5,248.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $1,047.13 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $691.83 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $4,897.79 | $4,897.79 | $4,897.79 |
Where Oregon sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.