How much rates vary
Facilitymedian $1,148 · 10th to 90th $832 to $8,913Professionalmedian $1,072 · 10th to 90th $589 to $1,622
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 $8,912.51 Typical High $18,620.87 | Facility | None | $5,128.61 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $891.25 | Professional | None | $707.95 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,230.27 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,621.81 | Professional | None | $707.95 | $977.24 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,479.11 | Professional | None | $954.99 | $1,174.90 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $18,620.87 | Facility | None | $891.25 | $1,412.54 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,513.56 | Professional | None | $870.96 | $933.25 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,202.26 | Facility | None | $691.83 | $1,096.48 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $3,019.95 Typical High $4,466.84 | Facility | None | $1,023.29 | $3,019.95 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,071.52 Typical High $1,737.80 | Professional | None | $79.43 | $1,071.52 | $1,737.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,302.69 Typical High $15,135.61 | Facility | None | $9,332.54 | $12,302.69 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,148.15 | $1,202.26 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,819.70 | Professional | None | $870.96 | $1,071.52 | $1,819.70 |
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 $323.59 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $128.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $478.63 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $95.50 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $64.57 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $446.68 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $162.18 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $602.56 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $616.60 |
Where Oregon sits
The same service costs 4.0 times more in Oklahoma than in Montana. 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
OK $7,771MT $1,932
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.