How much rates vary
Facilitymedian $832 · 10th to 90th $513 to $4,898Professionalmedian $776 · 10th to 90th $437 to $1,230
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $645.65 | Professional | None | $436.52 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,238.72 | Facility | None | $954.99 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,288.25 | Professional | None | $489.78 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,258.93 | Professional | None | $851.14 | $1,000.00 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $17,378.01 | Facility | None | $707.95 | $1,071.52 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,071.52 | Professional | None | $549.54 | $645.65 | $1,071.52 |
Pacific Source Setting Facility Modifier None Typical Low $478.63 Median $758.58 Typical High $891.25 | Facility | None | $478.63 | $758.58 | $891.25 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $2,398.83 | Facility | None | $794.33 | $1,513.56 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $776.25 Typical High $1,258.93 | Professional | None | $79.43 | $776.25 | $1,258.93 |
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 $870.96 Median $933.25 Typical High $1,174.90 | Professional | None | $870.96 | $933.25 | $1,174.90 |
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 $478.63 Median $741.31 Typical High $1,318.26 | Professional | None | $478.63 | $741.31 | $1,318.26 |
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 $257.04 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $77.62 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $457.09 |
Where Oregon sits
The same service costs 4.2 times more in Colorado than in Delaware. 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 $4,996DE $1,192
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.