How much rates vary
Facilitymedian $794 · 10th to 90th $513 to $5,129Professionalmedian $575 · 10th to 90th $302 to $1,000
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $575.44 | Professional | None | $251.19 | $398.11 | $575.44 |
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 $416.87 Median $602.56 Typical High $1,071.52 | Professional | None | $416.87 | $602.56 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $1,000.00 | Professional | None | $467.74 | $630.96 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $831.76 Typical High $7,943.28 | Facility | None | $575.44 | $831.76 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $758.58 | Professional | None | $263.03 | $446.68 | $758.58 |
Pacific Source Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $812.83 | Facility | None | $467.74 | $776.25 | $812.83 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $1,905.46 Typical High $3,162.28 | Facility | None | $616.60 | $1,905.46 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $602.56 Typical High $1,023.29 | Professional | None | $79.43 | $602.56 | $1,023.29 |
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 $549.54 Median $758.58 Typical High $870.96 | Professional | None | $549.54 | $758.58 | $870.96 |
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 $426.58 Median $691.83 Typical High $1,096.48 | Professional | None | $426.58 | $691.83 | $1,096.48 |
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 $162.18 Median $199.53 Typical High $288.40 | Professional | 52 · Reduced service | $162.18 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $81.28 Typical High $114.82 | Professional | 53 · Discontinued | $64.57 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $302.00 Typical High $436.52 | Professional | 54 · Surgery only | $245.47 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $39.81 Typical High $57.54 | Professional | 56 · Pre-op care only | $32.36 | $39.81 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $229.09 | $281.84 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $199.53 Typical High $288.40 | Professional | 52 · Reduced service | $162.18 | $199.53 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $81.28 Typical High $114.82 | Professional | 53 · Discontinued | $64.57 | $81.28 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $302.00 Typical High $436.52 | Professional | 54 · Surgery only | $245.47 | $302.00 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $39.81 Typical High $57.54 | Professional | 56 · Pre-op care only | $32.36 | $39.81 | $57.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $229.09 | $281.84 | $407.38 |
Where Oregon sits
The same service costs 6.1 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 $6,346MT $1,043
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.