How much rates vary
Facilitymedian $1,622 · 10th to 90th $933 to $2,512Professionalmedian $1,514 · 10th to 90th $759 to $2,291
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 $831.76 Median $1,258.93 Typical High $1,258.93 | Professional | None | $831.76 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $2,290.87 | Facility | None | $870.96 | $1,737.80 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,348.96 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,659.59 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $8,709.64 | Facility | None | $1,380.38 | $2,290.87 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,318.26 | $1,995.26 |
Pacific Source Setting Facility Modifier None Typical Low $977.24 Median $1,513.56 Typical High $1,698.24 | Facility | None | $977.24 | $1,513.56 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $2,290.87 | Facility | None | $977.24 | $1,737.80 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,548.82 Typical High $2,454.71 | Professional | None | $79.43 | $1,548.82 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $5,495.41 Typical High $7,585.78 | Facility | None | $2,454.71 | $5,495.41 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,698.24 | $2,187.76 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,548.82 | $2,570.40 |
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 $457.09 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $457.09 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $181.97 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $691.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $138.04 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $91.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $645.65 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $851.14 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $114.82 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $870.96 |
Where Oregon sits
The same service costs 4.3 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 $6,987KY $1,641
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.