How much rates vary
Facilitymedian $1,738 · 10th to 90th $933 to $7,943Professionalmedian $1,698 · 10th to 90th $813 to $2,692
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,445.44 | Professional | None | $812.83 | $1,174.90 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,621.81 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,949.84 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $7,943.28 | Facility | None | $1,174.90 | $2,137.96 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,344.23 | Professional | None | $891.25 | $1,445.44 | $2,344.23 |
Pacific Source Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $1,819.70 | Facility | None | $1,047.13 | $1,698.24 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $251,188.64 Typical High $251,188.64 | Facility | None | $1,023.29 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,698.24 Typical High $2,691.53 | Professional | None | $79.43 | $1,698.24 | $2,691.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,778.28 | $1,862.09 | $2,754.23 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,949.84 | $3,235.94 |
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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Where Oregon sits
The same service costs 10.1 times more in Maine than in Arkansas. 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
ME $16,050AR $1,584
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.