How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,318 to $8,511Professionalmedian $1,175 · 10th to 90th $479 to $3,020
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $1,318.26 Typical High $1,737.80 | Professional | None | $478.63 | $1,318.26 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,888.44 Typical High $8,128.31 | Facility | None | $1,000.00 | $5,888.44 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,174.90 Typical High $3,090.30 | Professional | None | $575.44 | $1,174.90 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $2,884.03 | Professional | None | $660.69 | $977.24 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $2,691.53 Typical High $17,378.01 | Facility | None | $691.83 | $2,691.53 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $1,737.80 Typical High $2,951.21 | Professional | None | $478.63 | $1,737.80 | $2,951.21 |
Pacific Source Setting Facility Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,454.71 | Facility | None | $1,348.96 | $2,041.74 | $2,454.71 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,128.31 | Facility | None | $776.25 | $4,786.30 | $8,128.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,047.13 Typical High $3,019.95 | Professional | None | $79.43 | $1,047.13 | $3,019.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,803.84 Median $19,054.61 Typical High $21,877.62 | Facility | None | $13,803.84 | $19,054.61 | $21,877.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $676.08 Median $1,230.27 Typical High $3,235.94 | Professional | None | $676.08 | $1,230.27 | $3,235.94 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,548.82 Typical High $3,388.44 | Professional | None | $660.69 | $1,548.82 | $3,388.44 |
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 $239.88 Median $275.42 Typical High $870.96 | Professional | 52 · Reduced service | $239.88 | $275.42 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $346.74 | Professional | 53 · Discontinued | $95.50 | $109.65 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $1,288.25 | Professional | 54 · Surgery only | $363.08 | $416.87 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $83.18 Typical High $257.04 | Professional | 55 · Aftercare only | $72.44 | $83.18 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $173.78 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $389.05 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $338.84 | $389.05 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $239.88 Typical High $870.96 | Professional | 52 · Reduced service | $239.88 | $239.88 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $346.74 | Professional | 53 · Discontinued | $95.50 | $95.50 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $1,288.25 | Professional | 54 · Surgery only | $363.08 | $363.08 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $257.04 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $173.78 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $1,202.26 |
Where Oregon sits
The same service costs 4.0 times more in Wisconsin than in North Dakota. 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 $9,724ND $2,433
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.