How much rates vary
Facilitymedian $1,479 · 10th to 90th $912 to $6,166Professionalmedian $1,230 · 10th to 90th $603 to $2,042
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 $676.08 Median $1,000.00 Typical High $1,230.27 | Professional | None | $676.08 | $1,000.00 | $1,230.27 |
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 $602.56 Median $1,148.15 Typical High $2,187.76 | Professional | None | $602.56 | $1,148.15 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,445.44 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $13,182.57 | Facility | None | $1,023.29 | $1,737.80 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $1,148.15 Typical High $1,737.80 | Professional | None | $691.83 | $1,148.15 | $1,737.80 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $1,548.82 | Facility | None | $891.25 | $1,445.44 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,000.00 | $1,862.09 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,230.27 Typical High $2,041.74 | Professional | None | $79.43 | $1,230.27 | $2,041.74 |
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 $1,230.27 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,479.11 | $1,778.28 |
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 $954.99 Median $1,348.96 Typical High $2,238.72 | Professional | None | $954.99 | $1,348.96 | $2,238.72 |
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 $489.78 Median $501.19 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $501.19 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $199.53 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | 54 · Surgery only | $758.58 | $758.58 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $851.14 |
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 3.7 times more in Alaska 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
AK $6,098WV $1,627
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.