How much rates vary
Facilitymedian $1,445 · 10th to 90th $1,000 to $13,183Professionalmedian $1,349 · 10th to 90th $741 to $1,995
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 $10,715.19 Typical High $18,620.87 | Facility | None | $5,128.61 | $10,715.19 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | None | $794.33 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $9,772.37 Typical High $13,182.57 | Facility | None | $1,230.27 | $9,772.37 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $2,041.74 | Professional | None | $776.25 | $1,230.27 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,479.11 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $18,620.87 | Facility | None | $1,202.26 | $1,995.26 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,122.02 | $1,659.59 |
Pacific Source Setting Facility Modifier None Typical Low $851.14 Median $1,380.38 Typical High $1,479.11 | Facility | None | $851.14 | $1,380.38 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $1,122.02 Median $8,709.64 Typical High $13,182.57 | Facility | None | $1,122.02 | $8,709.64 | $13,182.57 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,348.96 Typical High $2,041.74 | Professional | None | $79.43 | $1,348.96 | $2,041.74 |
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 $1,412.54 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,479.11 | $1,949.84 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $2,187.76 | Professional | None | $891.25 | $1,318.26 | $2,187.76 |
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 $416.87 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $416.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
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 6.2 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 $14,513MT $2,350
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.