How much rates vary
Facilitymedian $1,514 · 10th to 90th $912 to $6,607Professionalmedian $1,479 · 10th to 90th $813 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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $5,128.61 Typical High $6,918.31 | Facility | None | $660.69 | $5,128.61 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,412.54 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,548.82 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $7,943.28 | Facility | None | $1,122.02 | $2,089.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,202.26 | $2,089.30 |
Pacific Source Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $1,584.89 | Facility | None | $912.01 | $1,479.11 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $4,570.88 Typical High $6,918.31 | Facility | None | $676.08 | $4,570.88 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,445.44 Typical High $2,290.87 | Professional | None | $79.43 | $1,445.44 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,589.25 Median $17,782.79 Typical High $20,417.38 | Facility | None | $12,589.25 | $17,782.79 | $20,417.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,513.56 | $1,584.89 | $2,344.23 |
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 $1,148.15 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,621.81 | $2,754.23 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Where Oregon sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $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.