How much rates vary
Facilitymedian $871 · 10th to 90th $617 to $9,772Professionalmedian $813 · 10th to 90th $447 to $1,259
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 $758.58 Median $8,912.51 Typical High $18,620.87 | Facility | None | $758.58 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $758.58 | Professional | None | $457.09 | $616.60 | $758.58 |
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 $602.56 Median $794.33 Typical High $1,174.90 | Professional | None | $602.56 | $794.33 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,023.29 | Professional | None | $724.44 | $851.14 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $3,467.37 Typical High $13,803.84 | Facility | None | $758.58 | $3,467.37 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,258.93 | Professional | None | $478.63 | $660.69 | $1,258.93 |
Pacific Source Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $933.25 | Facility | None | $512.86 | $831.76 | $933.25 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $3,019.95 Typical High $4,466.84 | Facility | None | $851.14 | $3,019.95 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $831.76 Typical High $1,258.93 | Professional | None | $79.43 | $831.76 | $1,258.93 |
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 $831.76 Median $870.96 Typical High $1,288.25 | Professional | None | $831.76 | $870.96 | $1,288.25 |
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 $645.65 Median $1,000.00 Typical High $1,513.56 | Professional | None | $645.65 | $1,000.00 | $1,513.56 |
14 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 $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $870.96 Typical High $1,412.54 | Professional | 50 · Both sides | $371.54 | $870.96 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $18,620.87 Typical High $22,908.68 | Facility | 50 · Both sides | $13,803.84 | $18,620.87 | $22,908.68 |
Where Oregon sits
The same service costs 5.5 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 $7,406MT $1,352
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.