How much rates vary
Facilitymedian $1,549 · 10th to 90th $933 to $7,762Professionalmedian $1,549 · 10th to 90th $741 to $2,399
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 $933.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $933.25 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,818.38 Typical High $3,801.89 | Facility | None | $1,230.27 | $2,818.38 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,445.44 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,584.89 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $18,620.87 | Facility | None | $1,318.26 | $2,290.87 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,258.93 | $2,187.76 |
Pacific Source Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $1,659.59 | Facility | None | $912.01 | $1,479.11 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $1,122.02 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,122.02 | $2,570.40 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,513.56 Typical High $2,398.83 | Professional | None | $79.43 | $1,513.56 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,964.78 Typical High $12,882.50 | Facility | None | $7,413.10 | $10,964.78 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,548.82 | $1,659.59 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,698.24 | $2,818.38 |
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 $467.74 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $467.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $186.21 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $691.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $645.65 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $851.14 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $11,220.18 Median $16,595.87 Typical High $19,054.61 | Facility | 50 · Both sides | $11,220.18 | $16,595.87 | $19,054.61 |
Where Oregon sits
The same service costs 3.2 times more in Oklahoma 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
OK $7,412MD $2,297
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.