How much rates vary
Facilitymedian $891 · 10th to 90th $457 to $4,169Professionalmedian $832 · 10th to 90th $525 to $1,259
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $676.08 | Professional | None | $489.78 | $602.56 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $2,238.72 | Facility | None | $660.69 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,288.25 | Professional | None | $512.86 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,318.26 | Professional | None | $851.14 | $1,071.52 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $1,000.00 Typical High $6,918.31 | Facility | None | $676.08 | $1,000.00 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,023.29 | Professional | None | $602.56 | $676.08 | $1,023.29 |
Pacific Source Setting Facility Modifier None Typical Low $524.81 Median $812.83 Typical High $954.99 | Facility | None | $524.81 | $812.83 | $954.99 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $2,238.72 | Facility | None | $660.69 | $1,318.26 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $831.76 Typical High $1,288.25 | Professional | None | $79.43 | $831.76 | $1,288.25 |
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 $831.76 Median $933.25 Typical High $1,202.26 | Professional | None | $831.76 | $933.25 | $1,202.26 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $5,495.41 | Facility | None | $151.36 | $295.12 | $5,495.41 |
United Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,318.26 | Professional | None | $524.81 | $794.33 | $1,318.26 |
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 $269.15 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $269.15 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $426.58 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $302.00 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $120.23 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $457.09 | $457.09 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $467.74 |
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 5.3 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 $4,377FL $831
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.