How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,318 to $13,490Professionalmedian $1,778 · 10th to 90th $1,000 to $2,692
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 $13,489.63 Typical High $33,884.42 | Facility | None | $5,128.61 | $13,489.63 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | None | $977.24 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $8,709.64 Typical High $12,022.64 | Facility | None | $1,949.84 | $8,709.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,621.81 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,995.26 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $33,884.42 | Facility | None | $1,548.82 | $2,630.27 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,479.11 | $2,290.87 |
Pacific Source Setting Facility Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $1,995.26 | Facility | None | $1,122.02 | $1,862.09 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $1,659.59 Median $7,943.28 Typical High $12,022.64 | Facility | None | $1,659.59 | $7,943.28 | $12,022.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,778.28 Typical High $2,691.53 | Professional | None | $79.43 | $1,778.28 | $2,691.53 |
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 $1,862.09 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,862.09 | $1,995.26 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,801.89 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,801.89 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,737.80 | $2,884.03 |
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 $562.34 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $676.08 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $954.99 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $26,915.35 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $26,915.35 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 4.5 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 $14,231MT $3,134
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.