How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,380 to $8,511Professionalmedian $6,166 · 10th to 90th $2,884 to $9,333
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 $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
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 $4,265.80 Median $5,495.41 Typical High $8,511.38 | Professional | None | $4,265.80 | $5,495.41 | $8,511.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,370.32 Median $6,309.57 Typical High $7,585.78 | Professional | None | $5,370.32 | $6,309.57 | $7,585.78 |
Moda Health Setting Facility Modifier None Typical Low $4,466.84 Median $7,585.78 Typical High $8,709.64 | Facility | None | $4,466.84 | $7,585.78 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $4,073.80 Median $5,011.87 Typical High $8,709.64 | Professional | None | $4,073.80 | $5,011.87 | $8,709.64 |
Pacific Source Setting Facility Modifier None Typical Low $3,715.35 Median $5,888.44 Typical High $6,456.54 | Facility | None | $3,715.35 | $5,888.44 | $6,456.54 |
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 $5,888.44 Typical High $9,332.54 | Professional | None | $79.43 | $5,888.44 | $9,332.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $16,595.87 | Facility | None | $16,595.87 | $16,595.87 | $16,595.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $6,165.95 Median $6,456.54 Typical High $9,549.93 | Professional | None | $6,165.95 | $6,456.54 | $9,549.93 |
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 $4,677.35 Median $6,760.83 Typical High $11,220.18 | Professional | None | $4,677.35 | $6,760.83 | $11,220.18 |
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 $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $812.83 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,818.38 | $2,818.38 |
Where Oregon sits
The same service costs 10.8 times more in Maine than in Washington. 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 $36,725WA $3,399
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.