How much rates vary
Facilitymedian $4,169 · 10th to 90th $331 to $17,783Professionalmedian $1,023 · 10th to 90th $316 to $7,762
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $3,467.37 | Professional | None | $489.78 | $489.78 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $16,218.10 Typical High $21,877.62 | Facility | None | $660.69 | $16,218.10 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,412.54 Typical High $8,317.64 | Professional | None | $616.60 | $1,412.54 | $8,317.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $12,302.69 | Professional | None | $912.01 | $1,288.25 | $12,302.69 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $602.56 Typical High $7,943.28 | Facility | None | $363.08 | $602.56 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $794.33 Typical High $8,128.31 | Professional | None | $309.03 | $794.33 | $8,128.31 |
Pacific Source Setting Facility Modifier None Typical Low $288.40 Median $3,890.45 Typical High $7,413.10 | Facility | None | $288.40 | $3,890.45 | $7,413.10 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $11,481.54 Typical High $19,952.62 | Facility | None | $436.52 | $11,481.54 | $19,952.62 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $7,585.78 | Professional | None | $79.43 | $870.96 | $7,585.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $18,620.87 Median $37,153.52 Typical High $53,703.18 | Facility | None | $18,620.87 | $37,153.52 | $53,703.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $7,762.47 | Professional | None | $870.96 | $1,479.11 | $7,762.47 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $380.19 Median $1,230.27 Typical High $6,606.93 | Professional | None | $380.19 | $1,230.27 | $6,606.93 |
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 $245.47 Median $245.47 Typical High $1,737.80 | Professional | 52 · Reduced service | $245.47 | $245.47 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $691.83 | Professional | 53 · Discontinued | $97.72 | $97.72 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $2,630.27 | Professional | 54 · Surgery only | $363.08 | $363.08 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $524.81 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $346.74 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $2,454.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $245.47 Typical High $1,737.80 | Professional | 52 · Reduced service | $245.47 | $245.47 | $1,737.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $691.83 | Professional | 53 · Discontinued | $97.72 | $97.72 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $2,630.27 | Professional | 54 · Surgery only | $363.08 | $363.08 | $2,630.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $524.81 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $524.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $346.74 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $346.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $2,454.71 |
Where Oregon sits
The same service costs 18.4 times more in Alabama 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
AL $30,876MT $1,679
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.