How much rates vary
Facilitymedian $1,413 · 10th to 90th $977 to $5,370Professionalmedian $1,318 · 10th to 90th $724 to $1,995
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $977.24 | Professional | None | $676.08 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,000.00 | $1,819.70 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,995.26 | Professional | None | $758.58 | $1,202.26 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,479.11 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $2,041.74 Typical High $17,378.01 | Facility | None | $1,096.48 | $2,041.74 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,698.24 | Professional | None | $977.24 | $1,122.02 | $1,698.24 |
Pacific Source Setting Facility Modifier None Typical Low $851.14 Median $1,348.96 Typical High $1,479.11 | Facility | None | $851.14 | $1,348.96 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $2,511.89 | Facility | None | $1,000.00 | $1,737.80 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,348.96 Typical High $1,995.26 | Professional | None | $79.43 | $1,348.96 | $1,995.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,918.31 Typical High $7,762.47 | Facility | None | $5,128.61 | $6,918.31 | $7,762.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,479.11 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,318.26 Typical High $2,137.96 | Professional | None | $851.14 | $1,318.26 | $2,137.96 |
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 $426.58 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Oregon sits
The same service costs 3.0 times more in Alaska than in Maryland. 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 $5,643MD $1,856
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.