How much rates vary
Facilitymedian $631 · 10th to 90th $447 to $5,623Professionalmedian $589 · 10th to 90th $316 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 $562.34 Median $8,912.51 Typical High $18,620.87 | Facility | None | $562.34 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $478.63 | Professional | None | $316.23 | $457.09 | $478.63 |
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 $446.68 Median $575.44 Typical High $891.25 | Professional | None | $446.68 | $575.44 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $776.25 | Professional | None | $562.34 | $645.65 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $933.25 Typical High $18,620.87 | Facility | None | $562.34 | $933.25 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $912.01 | Professional | None | $338.84 | $478.63 | $912.01 |
Pacific Source Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $645.65 | Facility | None | $371.54 | $616.60 | $645.65 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $2,754.23 | Facility | None | $707.95 | $1,737.80 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $588.84 Typical High $933.25 | Professional | None | $79.43 | $588.84 | $933.25 |
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 $616.60 Median $645.65 Typical High $977.24 | Professional | None | $616.60 | $645.65 | $977.24 |
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 $467.74 Median $676.08 Typical High $1,122.02 | Professional | None | $467.74 | $676.08 | $1,122.02 |
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 $213.80 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $213.80 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $85.11 | $91.20 | $91.20 |
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 $42.66 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $42.66 | $45.71 | $45.71 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $91.20 | $91.20 | $91.20 |
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 $45.71 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
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 $7,943.28 Median $10,715.19 Typical High $12,302.69 | Facility | 50 · Both sides | $7,943.28 | $10,715.19 | $12,302.69 |
Where Oregon sits
The same service costs 5.1 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 $5,094MT $991
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.