How much rates vary
Facilitymedian $1,202 · 10th to 90th $724 to $7,943Professionalmedian $891 · 10th to 90th $457 to $1,549
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 $758.58 Median $7,943.28 Typical High $17,378.01 | Facility | None | $758.58 | $7,943.28 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $977.24 | Professional | None | $371.54 | $616.60 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,000.00 | $2,398.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,659.59 | Professional | None | $660.69 | $933.25 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,659.59 | Professional | None | $794.33 | $1,096.48 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $13,182.57 | Facility | None | $758.58 | $1,380.38 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,380.38 | Professional | None | $446.68 | $758.58 | $1,380.38 |
Pacific Source Setting Facility Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,288.25 | Facility | None | $691.83 | $1,096.48 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $2,041.74 Typical High $3,162.28 | Facility | None | $831.76 | $2,041.74 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $933.25 Typical High $1,584.89 | Professional | None | $79.43 | $933.25 | $1,584.89 |
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 $870.96 Median $1,174.90 Typical High $1,348.96 | Professional | None | $870.96 | $1,174.90 | $1,348.96 |
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 $630.96 Median $1,023.29 Typical High $1,698.24 | Professional | None | $630.96 | $1,023.29 | $1,698.24 |
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 $218.78 Median $309.03 Typical High $446.68 | Professional | 52 · Reduced service | $218.78 | $309.03 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $123.03 Typical High $177.83 | Professional | 53 · Discontinued | $89.13 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $457.09 Typical High $676.08 | Professional | 54 · Surgery only | $331.13 | $457.09 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $93.33 Typical High $134.90 | Professional | 55 · Aftercare only | $66.07 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $61.66 Typical High $89.13 | Professional | 56 · Pre-op care only | $44.67 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $309.03 | $426.58 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $309.03 Typical High $446.68 | Professional | 52 · Reduced service | $218.78 | $309.03 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $123.03 Typical High $177.83 | Professional | 53 · Discontinued | $87.10 | $123.03 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $457.09 Typical High $676.08 | Professional | 54 · Surgery only | $331.13 | $457.09 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $93.33 Typical High $134.90 | Professional | 55 · Aftercare only | $66.07 | $93.33 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $61.66 Typical High $89.13 | Professional | 56 · Pre-op care only | $43.65 | $61.66 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $426.58 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $309.03 | $426.58 | $630.96 |
Where Oregon sits
The same service costs 5.2 times more in Colorado than in West Virginia. 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 $6,580WV $1,277
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.