How much rates vary
Facilitymedian $1,175 · 10th to 90th $708 to $6,918Professionalmedian $1,096 · 10th to 90th $589 to $1,660
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 $588.84 Median $851.14 Typical High $851.14 | Professional | None | $588.84 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,000.00 | $2,398.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,698.24 | Professional | None | $645.65 | $1,023.29 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,288.25 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $17,378.01 | Facility | None | $831.76 | $1,659.59 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,380.38 | Professional | None | $616.60 | $851.14 | $1,380.38 |
Pacific Source Setting Facility Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,230.27 | Facility | None | $707.95 | $1,148.15 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $3,162.28 | Facility | None | $851.14 | $2,137.96 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,698.24 | Professional | None | $79.43 | $1,122.02 | $1,698.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $9,772.37 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,258.93 | $1,621.81 |
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 $691.83 Median $1,096.48 Typical High $1,819.70 | Professional | None | $691.83 | $1,096.48 | $1,819.70 |
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 $346.74 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $645.65 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $602.56 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $10,471.29 Median $14,791.08 Typical High $16,982.44 | Facility | 50 · Both sides | $10,471.29 | $14,791.08 | $16,982.44 |
Where Oregon sits
The same service costs 4.6 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 $6,475DE $1,401
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.