How much rates vary
Facilitymedian $1,259 · 10th to 90th $832 to $12,023Professionalmedian $1,148 · 10th to 90th $617 to $1,738
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $954.99 | Professional | None | $575.44 | $891.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $8,709.64 Typical High $12,022.64 | Facility | None | $1,000.00 | $8,709.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,778.28 | Professional | None | $676.08 | $1,071.52 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,318.26 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $17,378.01 | Facility | None | $1,047.13 | $1,698.24 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,479.11 | Professional | None | $660.69 | $977.24 | $1,479.11 |
Pacific Source Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $1,258.93 | Facility | None | $724.44 | $1,174.90 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $7,943.28 Typical High $12,022.64 | Facility | None | $1,000.00 | $7,943.28 | $12,022.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,148.15 Typical High $1,737.80 | Professional | None | $79.43 | $1,148.15 | $1,737.80 |
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 $1,230.27 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,288.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,011.87 Typical High $25,118.86 | Facility | None | $2,691.53 | $5,011.87 | $25,118.86 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,862.09 | Professional | None | $758.58 | $1,122.02 | $1,862.09 |
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 $363.08 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
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 6.8 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 $13,753MT $2,023
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.