How much rates vary
Facilitymedian $1,622 · 10th to 90th $912 to $7,762Professionalmedian $1,445 · 10th to 90th $708 to $2,239
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 $1,288.25 Median $5,128.61 Typical High $8,709.64 | Facility | None | $1,288.25 | $5,128.61 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,288.25 | Professional | None | $707.95 | $1,047.13 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $5,888.44 Typical High $8,128.31 | Facility | None | $891.25 | $5,888.44 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,412.54 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,513.56 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $8,709.64 | Facility | None | $1,148.15 | $1,778.28 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,995.26 | Professional | None | $707.95 | $1,047.13 | $1,995.26 |
Pacific Source Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $1,949.84 | Facility | None | $741.31 | $1,479.11 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $5,370.32 Typical High $8,709.64 | Facility | None | $891.25 | $5,370.32 | $8,709.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,479.11 Typical High $2,238.72 | Professional | None | $79.43 | $1,479.11 | $2,238.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $15,488.17 Median $22,387.21 Typical High $25,703.96 | Facility | None | $15,488.17 | $22,387.21 | $25,703.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,548.82 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $3,981.07 Typical High $22,908.68 | Facility | None | $1,995.26 | $3,981.07 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,949.84 | $2,630.27 |
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 $457.09 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $23,442.29 Median $33,113.11 Typical High $38,904.51 | Facility | 50 · Both sides | $23,442.29 | $33,113.11 | $38,904.51 |
Where Oregon sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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 $12,924HI $2,150
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.