How much rates vary
Facilitymedian $1,023 · 10th to 90th $631 to $4,571Professionalmedian $933 · 10th to 90th $501 to $1,445
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 $478.63 Median $741.31 Typical High $741.31 | Professional | None | $478.63 | $741.31 | $741.31 |
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 $562.34 Median $891.25 Typical High $1,479.11 | Professional | None | $562.34 | $891.25 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,348.96 | Professional | None | $933.25 | $1,096.48 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $8,709.64 | Facility | None | $812.83 | $1,445.44 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,202.26 | Professional | None | $537.03 | $741.31 | $1,202.26 |
Pacific Source Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,071.52 | Facility | None | $616.60 | $1,000.00 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $2,041.74 | Facility | None | $812.83 | $1,318.26 | $2,041.74 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $977.24 Typical High $1,479.11 | Professional | None | $79.43 | $977.24 | $1,479.11 |
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 $1,023.29 Median $1,071.52 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,071.52 | $1,412.54 |
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 $602.56 Median $954.99 Typical High $1,548.82 | Professional | None | $602.56 | $954.99 | $1,548.82 |
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 $302.00 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $147.91 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Where Oregon sits
The same service costs 4.0 times more in Colorado than in Maryland. 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 $5,106MD $1,261
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.