How much rates vary
Facilitymedian $11,220 · 10th to 90th $4,467 to $16,596Professionalmedian $1,445 · 10th to 90th $631 to $14,791
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 $10,232.93 Typical High $15,848.93 | Facility | None | $5,128.61 | $10,232.93 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $2,454.71 Typical High $10,715.19 | Professional | None | $676.08 | $2,454.71 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $14,454.40 Typical High $19,498.45 | Facility | None | $1,071.52 | $14,454.40 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,445.44 Typical High $15,488.17 | Professional | None | $630.96 | $1,445.44 | $15,488.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $14,791.08 | Professional | None | $758.58 | $1,174.90 | $14,791.08 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $12,022.64 Typical High $16,595.87 | Facility | None | $954.99 | $12,022.64 | $16,595.87 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $5,888.44 Typical High $12,589.25 | Professional | None | $676.08 | $5,888.44 | $12,589.25 |
Pacific Source Setting Facility Modifier None Typical Low $7,762.47 Median $11,220.18 Typical High $13,182.57 | Facility | None | $7,762.47 | $11,220.18 | $13,182.57 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $14,125.38 Typical High $19,498.45 | Facility | None | $933.25 | $14,125.38 | $19,498.45 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $1,288.25 Typical High $16,218.10 | Professional | None | $457.09 | $1,288.25 | $16,218.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,892.96 Typical High $40,738.03 | Facility | None | $14,454.40 | $20,892.96 | $40,738.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $831.76 Median $7,079.46 Typical High $12,302.69 | Professional | None | $831.76 | $7,079.46 | $12,302.69 |
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 $758.58 Median $6,165.95 Typical High $15,848.93 | Professional | None | $758.58 | $6,165.95 | $15,848.93 |
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 $331.13 Median $2,570.40 Typical High $5,370.32 | Professional | 52 · Reduced service | $331.13 | $2,570.40 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $1,023.29 Typical High $2,137.96 | Professional | 53 · Discontinued | $134.90 | $1,023.29 | $2,137.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $3,890.45 Typical High $8,128.31 | Professional | 54 · Surgery only | $501.19 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $776.25 Typical High $1,621.81 | Professional | 55 · Aftercare only | $100.00 | $776.25 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $512.86 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $67.61 | $512.86 | $1,071.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $3,630.78 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $467.74 | $3,630.78 | $7,585.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $1,230.27 Typical High $5,370.32 | Professional | 52 · Reduced service | $331.13 | $1,230.27 | $5,370.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $489.78 Typical High $2,137.96 | Professional | 53 · Discontinued | $134.90 | $489.78 | $2,137.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $1,862.09 Typical High $8,128.31 | Professional | 54 · Surgery only | $501.19 | $1,862.09 | $8,128.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $371.54 Typical High $1,621.81 | Professional | 55 · Aftercare only | $100.00 | $371.54 | $1,621.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $245.47 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $67.61 | $245.47 | $1,071.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $1,737.80 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $467.74 | $1,737.80 | $7,585.78 |
Where Oregon sits
The same service costs 4.1 times more in Iowa 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
IA $18,453DE $4,539
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.