How much rates vary
Facilitymedian $1,023 · 10th to 90th $676 to $50,119Professionalmedian $1,000 · 10th to 90th $501 to $1,549
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $912.01 | Professional | None | $501.19 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $50,118.72 Typical High $50,118.72 | Facility | None | $891.25 | $50,118.72 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,479.11 | Professional | None | $741.31 | $954.99 | $1,479.11 |
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 $1,000.00 Median $5,623.41 Typical High $8,709.64 | Facility | None | $1,000.00 | $5,623.41 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $1,513.56 | Professional | None | $549.54 | $870.96 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,096.48 | Facility | None | $602.56 | $1,000.00 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $45,708.82 Typical High $64,565.42 | Facility | None | $831.76 | $45,708.82 | $64,565.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $977.24 Typical High $1,584.89 | Professional | None | $79.43 | $977.24 | $1,584.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $57,543.99 Median $75,857.76 Typical High $93,325.43 | Facility | None | $57,543.99 | $75,857.76 | $93,325.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,096.48 | $1,621.81 |
United Setting Facility Modifier None Typical Low $3,548.13 Median $13,182.57 Typical High $63,095.73 | Facility | None | $3,548.13 | $13,182.57 | $63,095.73 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,862.09 | Professional | None | $758.58 | $1,096.48 | $1,862.09 |
13 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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $489.78 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $85,113.80 Median $114,815.36 Typical High $138,038.43 | Facility | 50 · Both sides | $85,113.80 | $114,815.36 | $138,038.43 |
Where Oregon sits
The same service costs 24.6 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 $43,875MT $1,787
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.