How much rates vary
Facilitymedian $3,548 · 10th to 90th $2,188 to $18,197Professionalmedian $3,311 · 10th to 90th $1,738 to $5,012
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 $18,197.01 | Facility | None | $5,128.61 | $7,943.28 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,691.53 | $2,691.53 |
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 $2,187.76 Median $2,951.21 Typical High $4,897.79 | Professional | None | $2,187.76 | $2,951.21 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $4,365.16 | Professional | None | $2,818.38 | $3,548.13 | $4,365.16 |
Moda Health Setting Facility Modifier None Typical Low $2,951.21 Median $4,365.16 Typical High $7,943.28 | Facility | None | $2,951.21 | $4,365.16 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $4,365.16 | Professional | None | $2,691.53 | $2,818.38 | $4,365.16 |
Pacific Source Setting Facility Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $3,715.35 | Facility | None | $2,187.76 | $3,548.13 | $3,715.35 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,023.29 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,388.44 Typical High $5,370.32 | Professional | None | $79.43 | $3,388.44 | $5,370.32 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,549.93 | Facility | None | $9,549.93 | $9,549.93 | $9,549.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,548.13 Median $3,715.35 Typical High $4,897.79 | Professional | None | $3,548.13 | $3,715.35 | $4,897.79 |
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 $2,691.53 Median $3,388.44 Typical High $5,754.40 | Professional | None | $2,691.53 | $3,388.44 | $5,754.40 |
8 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 54 · Surgery only Typical Low $1,513.56 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,513.56 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $302.00 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $199.53 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,862.09 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $371.54 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $245.47 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,905.46 | $1,905.46 |
Where Oregon sits
The same service costs 7.2 times more in Maine than in Delaware. 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 $28,702DE $3,966
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.