How much rates vary
Facilitymedian $1,413 · 10th to 90th $851 to $13,183Professionalmedian $1,259 · 10th to 90th $661 to $1,950
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 $1,230.27 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,230.27 | $7,943.28 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,230.27 | Professional | None | $660.69 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $9,120.11 Typical High $12,302.69 | Facility | None | $1,000.00 | $9,120.11 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,995.26 | Professional | None | $758.58 | $1,174.90 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,479.11 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $6,165.95 Typical High $21,379.62 | Facility | None | $1,230.27 | $6,165.95 | $21,379.62 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,905.46 | Professional | None | $660.69 | $1,096.48 | $1,905.46 |
Pacific Source Setting Facility Modifier None Typical Low $831.76 Median $1,318.26 Typical High $1,445.44 | Facility | None | $831.76 | $1,318.26 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $8,128.31 Typical High $12,302.69 | Facility | None | $1,000.00 | $8,128.31 | $12,302.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,318.26 Typical High $1,995.26 | Professional | None | $79.43 | $1,318.26 | $1,995.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,445.44 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,128.61 Typical High $25,118.86 | Facility | None | $2,691.53 | $5,128.61 | $25,118.86 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $2,089.30 | Professional | None | $851.14 | $1,288.25 | $2,089.30 |
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 $407.38 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $501.19 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $707.95 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $26,915.35 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $26,915.35 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 6.1 times more in Colorado than in Montana. 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 $13,882MT $2,270
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.