How much rates vary
Facilitymedian $1,148 · 10th to 90th $724 to $9,772Professionalmedian $1,000 · 10th to 90th $447 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 $831.76 Median $10,232.93 Typical High $24,547.09 | Facility | None | $831.76 | $10,232.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $891.25 | Professional | None | $446.68 | $676.08 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $3,311.31 Typical High $4,466.84 | Facility | None | $1,412.54 | $3,311.31 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $776.25 | $1,071.52 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,174.90 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $7,244.36 Typical High $15,848.93 | Facility | None | $831.76 | $7,244.36 | $15,848.93 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,621.81 | Professional | None | $524.81 | $831.76 | $1,621.81 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,148.15 | Facility | None | $645.65 | $1,000.00 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $3,019.95 Typical High $4,466.84 | Facility | None | $977.24 | $3,019.95 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,023.29 Typical High $1,698.24 | Professional | None | $79.43 | $1,023.29 | $1,698.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,715.19 Typical High $12,589.25 | Facility | None | $7,413.10 | $10,715.19 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,202.26 | $1,778.28 |
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 $812.83 Median $1,122.02 Typical High $2,041.74 | Professional | None | $812.83 | $1,122.02 | $2,041.74 |
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 $323.59 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $489.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $457.09 | $478.63 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $478.63 |
Where Oregon sits
The same service costs 3.6 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 $6,446MT $1,806
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.