How much rates vary
Facilitymedian $1,148 · 10th to 90th $741 to $5,754Professionalmedian $912 · 10th to 90th $447 to $1,479
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 $436.52 Median $691.83 Typical High $977.24 | Professional | None | $436.52 | $691.83 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $2,754.23 | Facility | None | $1,000.00 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $851.14 Typical High $1,584.89 | Professional | None | $446.68 | $851.14 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,445.44 | Professional | None | $741.31 | $1,071.52 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $1,318.26 Typical High $13,182.57 | Facility | None | $933.25 | $1,318.26 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $870.96 Typical High $1,348.96 | Professional | None | $489.78 | $870.96 | $1,348.96 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,174.90 | Facility | None | $660.69 | $1,096.48 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $1,778.28 Typical High $2,754.23 | Facility | None | $933.25 | $1,778.28 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $870.96 Typical High $1,479.11 | Professional | None | $79.43 | $870.96 | $1,479.11 |
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 $851.14 Median $1,096.48 Typical High $1,230.27 | Professional | None | $851.14 | $1,096.48 | $1,230.27 |
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 $676.08 Median $1,000.00 Typical High $1,659.59 | Professional | None | $676.08 | $1,000.00 | $1,659.59 |
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 $338.84 Median $346.74 Typical High $467.74 | Professional | 52 · Reduced service | $338.84 | $346.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $186.21 | Professional | 53 · Discontinued | $138.04 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $691.83 | Professional | 54 · Surgery only | $512.86 | $524.81 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $141.25 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $467.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | 53 · Discontinued | $141.25 | $141.25 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $524.81 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $645.65 |
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 4.0 times more in Oklahoma than in West Virginia. 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 $5,056WV $1,262
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.