How much rates vary
Facilitymedian $1,622 · 10th to 90th $912 to $7,943Professionalmedian $1,622 · 10th to 90th $832 to $2,455
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 $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,479.11 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,698.24 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $1,995.26 Typical High $7,943.28 | Facility | None | $933.25 | $1,995.26 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $2,238.72 | Professional | None | $851.14 | $1,348.96 | $2,238.72 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $1,698.24 | Facility | None | $1,000.00 | $1,621.81 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $251,188.64 Typical High $251,188.64 | Facility | None | $831.76 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $2,454.71 | Professional | None | $79.43 | $1,584.89 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,621.81 | $1,698.24 | $2,570.40 |
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 $1,258.93 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,778.28 | $2,951.21 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Where Oregon sits
The same service costs 18.1 times more in Maine than in Arkansas. 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
ME $27,451AR $1,513
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.