How much rates vary
Facilitymedian $1,148 · 10th to 90th $692 to $5,012Professionalmedian $1,096 · 10th to 90th $646 to $1,738
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 $645.65 Median $912.01 Typical High $912.01 | Professional | None | $645.65 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,090.30 Typical High $4,168.69 | Facility | None | $660.69 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,778.28 | Professional | None | $676.08 | $1,071.52 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,380.38 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $7,943.28 | Facility | None | $1,047.13 | $1,584.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,445.44 | Professional | None | $870.96 | $933.25 | $1,445.44 |
Pacific Source Setting Facility Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,288.25 | Facility | None | $691.83 | $1,096.48 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $2,754.23 Typical High $4,168.69 | Facility | None | $676.08 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,071.52 Typical High $1,778.28 | Professional | None | $79.43 | $1,071.52 | $1,778.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,481.54 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,481.54 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,288.25 | $1,698.24 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,819.70 | Professional | None | $724.44 | $1,071.52 | $1,819.70 |
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 $363.08 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
Where Oregon sits
The same service costs 5.0 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 $6,515DE $1,300
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.