How much rates vary
Facilitymedian $1,445 · 10th to 90th $1,000 to $8,318Professionalmedian $1,318 · 10th to 90th $646 to $2,089
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 $1,071.52 Median $7,943.28 Typical High $24,547.09 | Facility | None | $1,071.52 | $7,943.28 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,122.02 | Professional | None | $645.65 | $870.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $5,495.41 Typical High $7,585.78 | Facility | None | $1,412.54 | $5,495.41 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $2,041.74 | Professional | None | $977.24 | $1,318.26 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,412.54 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $6,025.60 Typical High $15,848.93 | Facility | None | $1,230.27 | $6,025.60 | $15,848.93 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $1,047.13 Typical High $2,137.96 | Professional | None | $645.65 | $1,047.13 | $2,137.96 |
Pacific Source Setting Facility Modifier None Typical Low $851.14 Median $1,380.38 Typical High $1,513.56 | Facility | None | $851.14 | $1,380.38 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $1,148.15 Median $5,011.87 Typical High $7,585.78 | Facility | None | $1,148.15 | $5,011.87 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,348.96 Typical High $2,187.76 | Professional | None | $79.43 | $1,348.96 | $2,187.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,589.25 Median $17,378.01 Typical High $19,952.62 | Facility | None | $12,589.25 | $17,378.01 | $19,952.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,513.56 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,801.89 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,801.89 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,479.11 | $2,570.40 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Where Oregon sits
The same service costs 4.5 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 $10,099MT $2,245
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.