How much rates vary
Facilitymedian $1,514 · 10th to 90th $891 to $5,623Professionalmedian $1,318 · 10th to 90th $589 to $2,291
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 $630.96 Median $1,258.93 Typical High $1,548.82 | Professional | None | $630.96 | $1,258.93 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $4,073.80 Typical High $5,623.41 | Facility | None | $660.69 | $4,073.80 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,380.38 Typical High $2,344.23 | Professional | None | $588.84 | $1,380.38 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,548.82 Typical High $1,819.70 | Professional | None | $707.95 | $1,548.82 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,344.23 Typical High $7,943.28 | Facility | None | $1,258.93 | $2,344.23 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $2,041.74 | Professional | None | $707.95 | $1,258.93 | $2,041.74 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,659.59 | Facility | None | $891.25 | $1,412.54 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $3,715.35 Typical High $5,623.41 | Facility | None | $676.08 | $3,715.35 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,318.26 Typical High $2,290.87 | Professional | None | $79.43 | $1,318.26 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $14,125.38 Typical High $17,378.01 | Facility | None | $11,481.54 | $14,125.38 | $17,378.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,659.59 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,412.54 | $2,630.27 |
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 $537.03 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $933.25 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $891.25 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $16,982.44 Median $21,379.62 Typical High $25,703.96 | Facility | 50 · Both sides | $16,982.44 | $21,379.62 | $25,703.96 |
Where Oregon sits
The same service costs 5.4 times more in Alaska than in South Carolina. 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 $8,807SC $1,633
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.