How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,318 to $18,197Professionalmedian $1,995 · 10th to 90th $1,072 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 $1,995.26 Median $5,128.61 Typical High $18,197.01 | Facility | None | $1,995.26 | $5,128.61 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,621.81 | $1,737.80 |
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 $1,318.26 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,737.80 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,621.81 | $2,041.74 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $2,630.27 Typical High $19,054.61 | Facility | None | $724.44 | $2,630.27 | $19,054.61 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,659.59 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $2,187.76 | Facility | None | $1,318.26 | $2,089.30 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,000.00 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,041.74 Typical High $3,235.94 | Professional | None | $79.43 | $2,041.74 | $3,235.94 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $14,454.40 Typical High $35,481.34 | Facility | None | $7,413.10 | $14,454.40 | $35,481.34 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,089.30 | $2,238.72 | $2,951.21 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,128.61 Typical High $25,118.86 | Facility | None | $2,691.53 | $5,128.61 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,137.96 | $3,467.37 |
6 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 $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $776.25 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $316.23 | $776.25 | $1,023.29 |
Moda Health Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $758.58 Typical High $851.14 | Professional | AS · PA/NP assist | $245.47 | $758.58 | $851.14 |
Where Oregon sits
The same service costs 8.7 times more in Maine 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
ME $27,149KY $3,127
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.