How much rates vary
Facilitymedian $1,122 · 10th to 90th $776 to $7,943Professionalmedian $1,072 · 10th to 90th $537 to $1,660
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 $537.03 Median $812.83 Typical High $812.83 | Professional | None | $537.03 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $4,365.16 | Facility | None | $1,230.27 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,584.89 | Professional | None | $776.25 | $1,023.29 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,348.96 | Professional | None | $977.24 | $1,122.02 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $1,513.56 Typical High $18,620.87 | Facility | None | $891.25 | $1,513.56 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,513.56 | Professional | None | $812.83 | $870.96 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,148.15 | Facility | None | $660.69 | $1,071.52 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $2,951.21 Typical High $4,365.16 | Facility | None | $954.99 | $2,951.21 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,047.13 Typical High $1,659.59 | Professional | None | $79.43 | $1,047.13 | $1,659.59 |
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 $1,096.48 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,148.15 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,995.26 | Professional | None | $831.76 | $1,174.90 | $1,995.26 |
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 $380.19 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $562.34 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Oregon sits
The same service costs 4.1 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 $7,274MT $1,783
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.