How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,698 to $8,318Professionalmedian $2,512 · 10th to 90th $1,660 to $3,981
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,412.54 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,511.89 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,754.23 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,754.23 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $19,952.62 | Facility | None | $1,949.84 | $3,388.44 | $19,952.62 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,737.80 | $2,290.87 | $3,388.44 |
Pacific Source Setting Facility Modifier None Typical Low $1,698.24 Median $2,754.23 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,754.23 | $2,951.21 |
Providence Setting Facility Modifier None Typical Low $1,445.44 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,445.44 | $4,897.79 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,630.27 Typical High $3,981.07 | Professional | None | $79.43 | $2,630.27 | $3,981.07 |
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 $2,290.87 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,290.87 | $2,951.21 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,884.03 | $4,365.16 |
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 $912.01 Median $912.01 Typical High $1,148.15 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $457.09 | Professional | 53 · Discontinued | $363.08 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,584.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $912.01 Typical High $1,148.15 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $457.09 | Professional | 53 · Discontinued | $363.08 | $363.08 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,584.89 |
Where Oregon sits
The same service costs 3.2 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 $12,311KY $3,892
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.