How much rates vary
Facilitymedian $1,549 · 10th to 90th $933 to $7,413Professionalmedian $1,413 · 10th to 90th $617 to $2,239
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 $812.83 Median $1,230.27 Typical High $1,230.27 | Professional | None | $812.83 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,398.83 Typical High $3,235.94 | Facility | None | $1,071.52 | $2,398.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,318.26 Typical High $2,238.72 | Professional | None | $616.60 | $1,318.26 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,479.11 Typical High $1,737.80 | Professional | None | $676.08 | $1,479.11 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,348.96 | $7,943.28 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $2,511.89 | Professional | None | $912.01 | $1,230.27 | $2,511.89 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,479.11 Typical High $1,584.89 | Facility | None | $891.25 | $1,479.11 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $1,230.27 Median $2,344.23 Typical High $3,388.44 | Facility | None | $1,230.27 | $2,344.23 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,445.44 Typical High $2,290.87 | Professional | None | $79.43 | $1,445.44 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,128.31 Typical High $9,332.54 | Facility | None | $6,025.60 | $8,128.31 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,584.89 | $1,949.84 |
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 $1,096.48 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,445.44 | $2,570.40 |
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 $501.19 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $602.56 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $239.88 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $9,120.11 Median $12,022.64 Typical High $13,803.84 | Facility | 50 · Both sides | $9,120.11 | $12,022.64 | $13,803.84 |
Where Oregon sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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
OK $7,181MS $1,948
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.