How much rates vary
Facilitymedian $776 · 10th to 90th $513 to $4,571Professionalmedian $692 · 10th to 90th $372 to $1,072
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 $354.81 Median $549.54 Typical High $549.54 | Professional | None | $354.81 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,238.72 | Facility | None | $891.25 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $1,096.48 | Professional | None | $416.87 | $660.69 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,023.29 | Professional | None | $707.95 | $812.83 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $8,709.64 | Facility | None | $645.65 | $1,047.13 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $933.25 | Professional | None | $398.11 | $575.44 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $457.09 Median $724.44 Typical High $776.25 | Facility | None | $457.09 | $724.44 | $776.25 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $1,513.56 Typical High $2,238.72 | Facility | None | $707.95 | $1,513.56 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $707.95 Typical High $1,071.52 | Professional | None | $79.43 | $707.95 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,023.29 | Professional | None | $758.58 | $794.33 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,148.15 | Professional | None | $467.74 | $691.83 | $1,148.15 |
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 $218.78 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $218.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $89.13 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,025.60 Median $8,317.64 Typical High $9,549.93 | Facility | 50 · Both sides | $6,025.60 | $8,317.64 | $9,549.93 |
Where Oregon sits
The same service costs 3.9 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 $4,902MT $1,262
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.