How much rates vary
Facilitymedian $1,549 · 10th to 90th $955 to $8,913Professionalmedian $1,349 · 10th to 90th $589 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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $1,230.27 | Professional | None | $707.95 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,230.27 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,348.96 Typical High $2,290.87 | Professional | None | $588.84 | $1,348.96 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,513.56 Typical High $1,778.28 | Professional | None | $691.83 | $1,513.56 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $18,620.87 | Facility | None | $1,202.26 | $2,089.30 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $724.44 Median $1,230.27 Typical High $2,089.30 | Professional | None | $724.44 | $1,230.27 | $2,089.30 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $1,621.81 | Facility | None | $891.25 | $1,445.44 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $1,202.26 Median $2,951.21 Typical High $4,466.84 | Facility | None | $1,202.26 | $2,951.21 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,348.96 Typical High $2,238.72 | Professional | None | $79.43 | $1,348.96 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $13,182.57 Typical High $15,135.61 | Facility | None | $9,332.54 | $13,182.57 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,621.81 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,412.54 | $2,630.27 |
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 $512.86 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $870.96 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $912.01 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $186.21 |
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 $851.14 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $870.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,803.84 Median $19,952.62 Typical High $22,387.21 | Facility | 50 · Both sides | $13,803.84 | $19,952.62 | $22,387.21 |
Where Oregon sits
The same service costs 3.6 times more in Vermont than in Montana. 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
VT $8,561MT $2,405
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.