How much rates vary
Facilitymedian $617 · 10th to 90th $417 to $28,184Professionalmedian $562 · 10th to 90th $316 to $851
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 $398.11 Median $416.87 Typical High $416.87 | Professional | None | $398.11 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $25,118.86 Typical High $34,673.69 | Facility | None | $660.69 | $25,118.86 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $870.96 | Professional | None | $331.13 | $512.86 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $851.14 | Professional | None | $588.84 | $691.83 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $7,943.28 | Facility | None | $478.63 | $831.76 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $741.31 | Professional | None | $416.87 | $489.78 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $363.08 Median $575.44 Typical High $645.65 | Facility | None | $363.08 | $575.44 | $645.65 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $22,387.21 Typical High $32,359.37 | Facility | None | $537.03 | $22,387.21 | $32,359.37 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $870.96 | Professional | None | $79.43 | $562.34 | $870.96 |
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 $602.56 Median $645.65 Typical High $831.76 | Professional | None | $602.56 | $645.65 | $831.76 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $6,918.31 Typical High $50,118.72 | Facility | None | $2,951.21 | $6,918.31 | $50,118.72 |
United Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $933.25 | Professional | None | $354.81 | $562.34 | $933.25 |
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 $181.97 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $275.42 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $257.04 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $316.23 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $295.12 |
Where Oregon sits
The same service costs 29.1 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 $30,626MT $1,051
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.