How much rates vary
Facilitymedian $1,349 · 10th to 90th $871 to $8,318Professionalmedian $1,202 · 10th to 90th $490 to $2,042
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 $1,148.15 Typical High $1,174.90 | Professional | None | $676.08 | $1,148.15 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,230.27 Typical High $2,089.30 | Professional | None | $489.78 | $1,230.27 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,412.54 Typical High $1,698.24 | Professional | None | $645.65 | $1,412.54 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $17,378.01 | Facility | None | $1,047.13 | $1,737.80 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,905.46 | Professional | None | $776.25 | $1,148.15 | $1,905.46 |
Pacific Source Setting Facility Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,479.11 | Facility | None | $776.25 | $1,202.26 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $2,951.21 Typical High $4,466.84 | Facility | None | $1,023.29 | $2,951.21 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,174.90 Typical High $2,041.74 | Professional | None | $79.43 | $1,174.90 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $13,182.57 Typical High $15,135.61 | Facility | None | $9,332.54 | $13,182.57 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,479.11 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,398.83 | Professional | None | $933.25 | $1,258.93 | $2,398.83 |
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 $478.63 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $194.98 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $562.34 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $19,952.62 Typical High $22,387.21 | Facility | 50 · Both sides | $13,803.84 | $19,952.62 | $22,387.21 |
Where Oregon sits
The same service costs 3.6 times more in Wisconsin 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
WI $8,021MT $2,220
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.