How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,622 to $9,772Professionalmedian $2,630 · 10th to 90th $1,318 to $4,074
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 $13,489.63 Typical High $33,884.42 | Facility | None | $5,128.61 | $13,489.63 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $2,187.76 | Professional | None | $1,584.89 | $2,137.96 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,949.84 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,981.07 | Professional | None | $1,862.09 | $2,570.40 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,818.38 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,890.45 Typical High $33,884.42 | Facility | None | $2,137.96 | $3,890.45 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,819.70 | $2,137.96 | $3,715.35 |
Pacific Source Setting Facility Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $2,818.38 | Facility | None | $1,584.89 | $2,570.40 | $2,818.38 |
Providence Setting Facility Modifier None Typical Low $1,949.84 Median $5,128.61 Typical High $7,762.47 | Facility | None | $1,949.84 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,570.40 Typical High $4,073.80 | Professional | None | $79.43 | $2,570.40 | $4,073.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $23,442.29 | Facility | None | $14,454.40 | $20,417.38 | $23,442.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $4,168.69 | Professional | None | $2,691.53 | $2,818.38 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,951.21 Typical High $4,897.79 | Professional | None | $1,995.26 | $2,951.21 | $4,897.79 |
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 $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $794.33 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $316.23 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,174.90 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $234.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $158.49 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,513.56 | $1,513.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,513.56 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $21,877.62 Median $30,199.52 Typical High $34,673.69 | Facility | 50 · Both sides | $21,877.62 | $30,199.52 | $34,673.69 |
Where Oregon sits
The same service costs 3.0 times more in Alaska than in Vermont. 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 $12,999VT $4,294
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.