How much rates vary
Facilitymedian $646 · 10th to 90th $437 to $4,571Professionalmedian $589 · 10th to 90th $339 to $912
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 $338.84 Median $467.74 Typical High $467.74 | Professional | None | $338.84 | $467.74 | $467.74 |
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 $354.81 Median $549.54 Typical High $933.25 | Professional | None | $354.81 | $549.54 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $870.96 | Professional | None | $588.84 | $691.83 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $8,709.64 | Facility | None | $512.86 | $870.96 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $776.25 | Professional | None | $467.74 | $489.78 | $776.25 |
Pacific Source Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $660.69 | Facility | None | $371.54 | $602.56 | $660.69 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $1,513.56 Typical High $2,238.72 | Facility | None | $630.96 | $1,513.56 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $575.44 Typical High $912.01 | Professional | None | $79.43 | $575.44 | $912.01 |
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 $630.96 Median $660.69 Typical High $870.96 | Professional | None | $630.96 | $660.69 | $870.96 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $954.99 | Professional | None | $363.08 | $575.44 | $954.99 |
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 $186.21 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $74.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $281.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $263.03 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $346.74 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $323.59 |
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 4.6 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 $4,822MT $1,050
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.