How much rates vary
Facilitymedian $1,148 · 10th to 90th $692 to $5,012Professionalmedian $1,000 · 10th to 90th $457 to $1,698
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 $549.54 Median $933.25 Typical High $933.25 | Professional | None | $549.54 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,344.23 Typical High $3,235.94 | Facility | None | $660.69 | $2,344.23 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,000.00 Typical High $1,698.24 | Professional | None | $457.09 | $1,000.00 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $1,122.02 Typical High $1,318.26 | Professional | None | $512.86 | $1,122.02 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $1,584.89 Typical High $7,943.28 | Facility | None | $933.25 | $1,584.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,548.82 | Professional | None | $616.60 | $933.25 | $1,548.82 |
Pacific Source Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,202.26 | Facility | None | $676.08 | $1,096.48 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,137.96 Typical High $3,235.94 | Facility | None | $660.69 | $2,137.96 | $3,235.94 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,000.00 Typical High $1,698.24 | Professional | None | $79.43 | $1,000.00 | $1,698.24 |
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 $1,122.02 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,202.26 | $1,479.11 |
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 $812.83 Median $1,096.48 Typical High $1,949.84 | Professional | None | $812.83 | $1,096.48 | $1,949.84 |
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 $389.05 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
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 3.3 times more in Alaska than in Hawaii. 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 $5,766HI $1,731
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.