How much rates vary
Facilitymedian $646 · 10th to 90th $457 to $8,318Professionalmedian $589 · 10th to 90th $309 to $912
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 $575.44 Median $8,317.64 Typical High $17,378.01 | Facility | None | $575.44 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $575.44 | Professional | None | $316.23 | $467.74 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,235.94 Typical High $4,365.16 | Facility | None | $1,000.00 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $912.01 | Professional | None | $446.68 | $588.84 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $794.33 | Professional | None | $575.44 | $660.69 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $2,818.38 Typical High $13,182.57 | Facility | None | $575.44 | $2,818.38 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $870.96 | Professional | None | $323.59 | $489.78 | $870.96 |
Pacific Source Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $660.69 | Facility | None | $380.19 | $616.60 | $660.69 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,884.03 Typical High $4,365.16 | Facility | None | $660.69 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $602.56 Typical High $954.99 | Professional | None | $79.43 | $602.56 | $954.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $12,022.64 Typical High $13,803.84 | Facility | None | $8,912.51 | $12,022.64 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $977.24 | Professional | None | $630.96 | $660.69 | $977.24 |
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 $478.63 Median $676.08 Typical High $1,148.15 | Professional | None | $478.63 | $676.08 | $1,148.15 |
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 $218.78 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $323.59 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,489.63 Median $18,197.01 Typical High $20,892.96 | Facility | 50 · Both sides | $13,489.63 | $18,197.01 | $20,892.96 |
Where Oregon sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.