How much rates vary
Facilitymedian $759 · 10th to 90th $513 to $32,359Professionalmedian $708 · 10th to 90th $372 to $1,047
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 $354.81 Median $512.86 Typical High $512.86 | Professional | None | $354.81 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $28,840.32 Typical High $39,810.72 | Facility | None | $891.25 | $28,840.32 | $39,810.72 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $1,071.52 | Professional | None | $398.11 | $630.96 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,000.00 | Professional | None | $691.83 | $812.83 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $1,071.52 Typical High $8,709.64 | Facility | None | $724.44 | $1,071.52 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $933.25 | Professional | None | $407.38 | $616.60 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $776.25 | Facility | None | $446.68 | $741.31 | $776.25 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $25,703.96 Typical High $37,153.52 | Facility | None | $724.44 | $25,703.96 | $37,153.52 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $724.44 Typical High $1,071.52 | Professional | None | $79.43 | $724.44 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $48,977.88 Median $61,659.50 Typical High $74,131.02 | Facility | None | $48,977.88 | $61,659.50 | $74,131.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,023.29 | Professional | None | $741.31 | $776.25 | $1,023.29 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $13,803.84 Typical High $63,095.73 | Facility | None | $4,365.16 | $13,803.84 | $63,095.73 |
United Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,148.15 | Professional | None | $512.86 | $691.83 | $1,148.15 |
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 $223.87 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $316.23 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $363.08 |
Where Oregon sits
The same service costs 29.4 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 $37,066MT $1,262
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.