How much rates vary
Facilitymedian $1,995 · 10th to 90th $1,380 to $13,183Professionalmedian $1,995 · 10th to 90th $955 to $3,020
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 $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,513.56 | $1,513.56 |
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 $1,412.54 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,862.09 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,949.84 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $33,884.42 | Facility | None | $1,659.59 | $2,951.21 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,621.81 | $2,691.53 |
Pacific Source Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,089.30 | Facility | None | $1,202.26 | $1,905.46 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $1,659.59 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,659.59 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,949.84 Typical High $3,019.95 | Professional | None | $79.43 | $1,949.84 | $3,019.95 |
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 $1,995.26 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,995.26 | $2,089.30 | $3,090.30 |
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 $1,513.56 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,513.56 | $2,238.72 | $3,548.13 |
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 $602.56 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $851.14 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
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 3.6 times more in Alaska 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
AK $11,248MT $3,134
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.