How much rates vary
Facilitymedian $550 · 10th to 90th $331 to $5,623Professionalmedian $457 · 10th to 90th $245 to $794
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 $331.13 Median $5,128.61 Typical High $8,709.64 | Facility | None | $331.13 | $5,128.61 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $426.58 | Professional | None | $218.78 | $275.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,235.94 Typical High $4,466.84 | Facility | None | $891.25 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $831.76 | Professional | None | $338.84 | $489.78 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $707.95 | Professional | None | $398.11 | $549.54 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $776.25 Typical High $8,511.38 | Facility | None | $346.74 | $776.25 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $660.69 | Professional | None | $234.42 | $346.74 | $660.69 |
Pacific Source Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $588.84 | Facility | None | $323.59 | $489.78 | $588.84 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $2,630.27 Typical High $4,466.84 | Facility | None | $371.54 | $2,630.27 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $794.33 | Professional | None | $79.43 | $489.78 | $794.33 |
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 $446.68 Median $575.44 Typical High $812.83 | Professional | None | $446.68 | $575.44 | $812.83 |
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 $346.74 Median $537.03 Typical High $891.25 | Professional | None | $346.74 | $537.03 | $891.25 |
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 $134.90 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $53.70 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $134.90 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $53.70 | $53.70 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $204.17 | $204.17 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $34.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $245.47 |
Where Oregon sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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 $5,029WV $590
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.