How much rates vary
Facilitymedian $1,023 · 10th to 90th $617 to $4,074Professionalmedian $813 · 10th to 90th $468 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 $794.33 Median $5,128.61 Typical High $8,709.64 | Facility | None | $794.33 | $5,128.61 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $812.83 | Professional | None | $354.81 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,905.46 | Facility | None | $812.83 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,380.38 | Professional | None | $501.19 | $812.83 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,479.11 | Professional | None | $645.65 | $933.25 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $1,148.15 Typical High $7,943.28 | Facility | None | $676.08 | $1,148.15 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,148.15 | Professional | None | $467.74 | $741.31 | $1,148.15 |
Pacific Source Setting Facility Modifier None Typical Low $616.60 Median $954.99 Typical High $1,122.02 | Facility | None | $616.60 | $954.99 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $1,258.93 Typical High $1,905.46 | Facility | None | $707.95 | $1,258.93 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $812.83 Typical High $1,380.38 | Professional | None | $79.43 | $812.83 | $1,380.38 |
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 $645.65 Median $1,023.29 Typical High $1,122.02 | Professional | None | $645.65 | $1,023.29 | $1,122.02 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $1,445.44 | Professional | None | $489.78 | $812.83 | $1,445.44 |
12 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 $234.42 Median $239.88 Typical High $407.38 | Professional | 52 · Reduced service | $234.42 | $239.88 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $162.18 | Professional | 53 · Discontinued | $93.33 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $602.56 | Professional | 54 · Surgery only | $354.81 | $354.81 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $120.23 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $234.42 Typical High $407.38 | Professional | 52 · Reduced service | $234.42 | $234.42 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $162.18 | Professional | 53 · Discontinued | $93.33 | $93.33 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $602.56 | Professional | 54 · Surgery only | $354.81 | $354.81 | $602.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $120.23 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $81.28 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $562.34 |
Where Oregon sits
The same service costs 4.4 times more in Colorado than in West Virginia. 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 $4,828WV $1,100
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.