How much rates vary
Facilitymedian $1,738 · 10th to 90th $1,175 to $5,754Professionalmedian $1,585 · 10th to 90th $676 to $2,754
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 $10,232.93 Typical High $24,547.09 | Facility | None | $5,128.61 | $10,232.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,513.56 Typical High $1,513.56 | Professional | None | $758.58 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $2,754.23 | Facility | None | $1,202.26 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,621.81 Typical High $2,818.38 | Professional | None | $676.08 | $1,621.81 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,862.09 Typical High $2,238.72 | Professional | None | $870.96 | $1,862.09 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $24,547.09 | Facility | None | $1,412.54 | $2,398.83 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $1,513.56 Typical High $2,511.89 | Professional | None | $831.76 | $1,513.56 | $2,511.89 |
Pacific Source Setting Facility Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $1,995.26 | Facility | None | $1,047.13 | $1,621.81 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $2,951.21 | Facility | None | $1,258.93 | $2,041.74 | $2,951.21 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $2,754.23 | Professional | None | $79.43 | $1,584.89 | $2,754.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $9,332.54 | Facility | None | $5,754.40 | $8,128.31 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,862.09 | $1,995.26 | $2,398.83 |
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 $1,258.93 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,258.93 | $1,698.24 | $3,162.28 |
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 $645.65 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $645.65 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,071.52 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $12,302.69 Typical High $13,803.84 | Facility | 50 · Both sides | $8,709.64 | $12,302.69 | $13,803.84 |
Where Oregon sits
The same service costs 3.1 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 $6,735MD $2,157
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.