How much rates vary
Facilitymedian $1,047 · 10th to 90th $631 to $4,365Professionalmedian $1,000 · 10th to 90th $589 to $1,479
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 $870.96 Median $1,288.25 Typical High $13,182.57 | Facility | None | $870.96 | $1,288.25 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $954.99 | Professional | None | $537.03 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,238.72 | Facility | None | $954.99 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,479.11 | Professional | None | $588.84 | $912.01 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,318.26 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $7,943.28 | Facility | None | $758.58 | $1,288.25 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,288.25 | Professional | None | $602.56 | $851.14 | $1,288.25 |
Pacific Source Setting Facility Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,096.48 | Facility | None | $630.96 | $1,023.29 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,238.72 | Facility | None | $870.96 | $1,445.44 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,000.00 Typical High $1,548.82 | Professional | None | $79.43 | $1,000.00 | $1,548.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,309.57 | Facility | None | $4,073.80 | $5,623.41 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,071.52 | $1,380.38 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,621.81 | Professional | None | $676.08 | $954.99 | $1,621.81 |
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 $316.23 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $316.23 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $363.08 | $363.08 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $144.54 | $144.54 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $575.44 | Professional | 54 · Surgery only | $549.54 | $549.54 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $537.03 |
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 4.0 times more in Colorado than in Florida. 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 $4,440FL $1,118
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.