How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,479 to $10,233Professionalmedian $2,291 · 10th to 90th $1,175 to $3,467
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $6,918.31 Typical High $9,549.93 | Facility | None | $1,412.54 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,348.96 | $2,137.96 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,570.40 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $24,547.09 | Facility | None | $1,995.26 | $3,548.13 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,862.09 | $2,884.03 |
Pacific Source Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $2,570.40 | Facility | None | $1,479.11 | $2,398.83 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $1,479.11 Median $6,309.57 Typical High $9,549.93 | Facility | None | $1,479.11 | $6,309.57 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,344.23 Typical High $3,548.13 | Professional | None | $79.43 | $2,344.23 | $3,548.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,570.40 | $3,388.44 |
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 $1,548.82 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,548.82 | $2,290.87 | $3,801.89 |
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 $724.44 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $295.12 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $147.91 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,258.93 | $1,258.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,258.93 |
Where Oregon sits
The same service costs 4.0 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 $14,661HI $3,664
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.