How much rates vary
Facilitymedian $1,096 · 10th to 90th $776 to $15,849Professionalmedian $1,000 · 10th to 90th $501 to $1,549
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 $1,047.13 Median $12,302.69 Typical High $33,884.42 | Facility | None | $1,047.13 | $12,302.69 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $870.96 | Professional | None | $537.03 | $851.14 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,949.84 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,548.82 | Professional | None | $660.69 | $933.25 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,412.54 | Professional | None | $912.01 | $1,148.15 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $7,943.28 Typical High $21,379.62 | Facility | None | $851.14 | $7,943.28 | $21,379.62 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,659.59 | Professional | None | $562.34 | $851.14 | $1,659.59 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,148.15 | Facility | None | $660.69 | $1,047.13 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,288.25 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,023.29 Typical High $1,659.59 | Professional | None | $79.43 | $1,023.29 | $1,659.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $19,952.62 Typical High $22,908.68 | Facility | None | $14,454.40 | $19,952.62 | $22,908.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,148.15 | $1,513.56 |
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 $831.76 Median $1,023.29 Typical High $1,737.80 | Professional | None | $831.76 | $1,023.29 | $1,737.80 |
13 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 $309.03 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $123.03 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $457.09 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $91.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $61.66 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $426.58 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $416.87 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $588.84 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $21,379.62 Median $30,199.52 Typical High $34,673.69 | Facility | 50 · Both sides | $21,379.62 | $30,199.52 | $34,673.69 |
Where Oregon sits
The same service costs 6.0 times more in Wisconsin 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
WI $11,096MT $1,846
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.