How much rates vary
Facilitymedian $1,023 · 10th to 90th $724 to $6,026Professionalmedian $794 · 10th to 90th $501 to $1,288
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 $3,890.45 Median $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $776.25 | Professional | None | $398.11 | $549.54 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,344.23 Typical High $3,162.28 | Facility | None | $891.25 | $2,344.23 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,318.26 | Professional | None | $549.54 | $776.25 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,380.38 | Professional | None | $741.31 | $1,023.29 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,122.02 Typical High $7,943.28 | Facility | None | $776.25 | $1,122.02 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,148.15 | Professional | None | $501.19 | $776.25 | $1,148.15 |
Pacific Source Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,071.52 | Facility | None | $616.60 | $1,000.00 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $3,162.28 | Facility | None | $794.33 | $1,905.46 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $812.83 Typical High $1,318.26 | Professional | None | $79.43 | $812.83 | $1,318.26 |
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 $758.58 Median $1,000.00 Typical High $1,122.02 | Professional | None | $758.58 | $1,000.00 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,412.54 | Professional | None | $575.44 | $851.14 | $1,412.54 |
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 $275.42 Median $275.42 Typical High $389.05 | Professional | 52 · Reduced service | $275.42 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $154.88 | Professional | 53 · Discontinued | $109.65 | $109.65 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $588.84 | Professional | 54 · Surgery only | $416.87 | $416.87 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $117.49 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | 52 · Reduced service | $275.42 | $275.42 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $154.88 | Professional | 53 · Discontinued | $109.65 | $109.65 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $588.84 | Professional | 54 · Surgery only | $416.87 | $416.87 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $117.49 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $549.54 |
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 4.7 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 $6,464MT $1,390
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.