How much rates vary
Facilitymedian $646 · 10th to 90th $447 to $7,762Professionalmedian $525 · 10th to 90th $380 to $832
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $512.86 | Professional | None | $346.74 | $389.05 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,623.41 Typical High $7,762.47 | Facility | None | $891.25 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $870.96 | Professional | None | $363.08 | $489.78 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $794.33 | Professional | None | $436.52 | $616.60 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $8,709.64 | Facility | None | $501.19 | $724.44 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $758.58 | Professional | None | $389.05 | $512.86 | $758.58 |
Pacific Source Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $660.69 | Facility | None | $371.54 | $616.60 | $660.69 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $4,570.88 Typical High $7,762.47 | Facility | None | $549.54 | $4,570.88 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $870.96 | Professional | None | $79.43 | $537.03 | $870.96 |
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 $501.19 Median $630.96 Typical High $776.25 | Professional | None | $501.19 | $630.96 | $776.25 |
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 $407.38 Median $549.54 Typical High $891.25 | Professional | None | $407.38 | $549.54 | $891.25 |
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 $177.83 Median $194.98 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $380.19 | Professional | 54 · Surgery only | $263.03 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $75.86 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $194.98 Typical High $257.04 | Professional | 52 · Reduced service | $177.83 | $194.98 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $102.33 | Professional | 53 · Discontinued | $70.79 | $77.62 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $380.19 | Professional | 54 · Surgery only | $269.15 | $288.40 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $75.86 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $51.29 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $354.81 |
Where Oregon sits
The same service costs 8.7 times more in Alaska 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
AK $7,504ND $861
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.