How much rates vary
Facilitymedian $575 · 10th to 90th $389 to $6,166Professionalmedian $537 · 10th to 90th $288 to $813
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $467.74 | Professional | None | $288.40 | $380.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $2,570.40 | Facility | None | $1,096.48 | $1,905.46 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $812.83 | Professional | None | $398.11 | $524.81 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $724.44 | Professional | None | $512.86 | $588.84 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,096.48 Typical High $18,620.87 | Facility | None | $457.09 | $1,096.48 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $741.31 | Professional | None | $302.00 | $436.52 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $338.84 Median $549.54 Typical High $588.84 | Facility | None | $338.84 | $549.54 | $588.84 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $1,737.80 Typical High $2,754.23 | Facility | None | $630.96 | $1,737.80 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $851.14 | Professional | None | $79.43 | $537.03 | $851.14 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $8,128.31 | Facility | None | $5,248.07 | $7,244.36 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $870.96 | Professional | None | $562.34 | $588.84 | $870.96 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $1,023.29 | Professional | None | $426.58 | $602.56 | $1,023.29 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $269.15 |
Where Oregon sits
The same service costs 6.6 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 $6,126MT $925
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.