How much rates vary
Facilitymedian $513 · 10th to 90th $295 to $2,884Professionalmedian $372 · 10th to 90th $191 to $617
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 $302.00 Median $5,623.41 Typical High $8,709.64 | Facility | None | $302.00 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $426.58 | Professional | None | $173.78 | $245.47 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,344.23 Typical High $3,162.28 | Facility | None | $891.25 | $2,344.23 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $707.95 | Professional | None | $263.03 | $389.05 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $691.83 | Professional | None | $323.59 | $436.52 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $489.78 Typical High $7,943.28 | Facility | None | $302.00 | $489.78 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $512.86 | Professional | None | $190.55 | $309.03 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $288.40 Median $478.63 Typical High $1,819.70 | Facility | None | $288.40 | $478.63 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $1,905.46 Typical High $3,162.28 | Facility | None | $398.11 | $1,905.46 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $389.05 Typical High $660.69 | Professional | None | $79.43 | $389.05 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $9,772.37 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $562.34 | Professional | None | $346.74 | $489.78 | $562.34 |
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 $263.03 Median $426.58 Typical High $707.95 | Professional | None | $263.03 | $426.58 | $707.95 |
12 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 $95.50 Median $123.03 Typical High $186.21 | Professional | 52 · Reduced service | $95.50 | $123.03 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $75.86 | Professional | 53 · Discontinued | $38.02 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $186.21 Typical High $281.84 | Professional | 54 · Surgery only | $144.54 | $186.21 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $56.23 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $37.15 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $173.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $134.90 | $173.78 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $123.03 Typical High $186.21 | Professional | 52 · Reduced service | $95.50 | $123.03 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $75.86 | Professional | 53 · Discontinued | $38.02 | $48.98 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $186.21 Typical High $281.84 | Professional | 54 · Surgery only | $144.54 | $186.21 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $56.23 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $37.15 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $37.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $173.78 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $134.90 | $173.78 | $346.74 |
Where Oregon sits
The same service costs 9.3 times more in Colorado 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
CO $5,912MT $637
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.