How much rates vary
Facilitymedian $661 · 10th to 90th $389 to $4,365Professionalmedian $631 · 10th to 90th $363 to $1,000
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 $363.08 Median $501.19 Typical High $501.19 | Professional | None | $363.08 | $501.19 | $501.19 |
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 $398.11 Median $630.96 Typical High $1,047.13 | Professional | None | $398.11 | $630.96 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,023.29 | Professional | None | $691.83 | $812.83 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $912.01 Typical High $7,943.28 | Facility | None | $537.03 | $912.01 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $831.76 | Professional | None | $457.09 | $512.86 | $831.76 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $630.96 Typical High $724.44 | Facility | None | $398.11 | $630.96 | $724.44 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,513.56 Typical High $2,238.72 | Facility | None | $660.69 | $1,513.56 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $630.96 Typical High $1,023.29 | Professional | None | $79.43 | $630.96 | $1,023.29 |
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 $707.95 Median $741.31 Typical High $954.99 | Professional | None | $707.95 | $741.31 | $954.99 |
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 $389.05 Median $616.60 Typical High $1,071.52 | Professional | None | $389.05 | $616.60 | $1,071.52 |
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 $204.17 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $281.84 | $354.81 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
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 5.9 times more in Colorado than in Kentucky. 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 $4,303KY $729
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.