How much rates vary
Facilitymedian $537 · 10th to 90th $389 to $5,012Professionalmedian $501 · 10th to 90th $269 to $741
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 $263.03 Median $389.05 Typical High $407.38 | Professional | None | $263.03 | $389.05 | $407.38 |
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 $295.12 Median $446.68 Typical High $741.31 | Professional | None | $295.12 | $446.68 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $691.83 | Professional | None | $478.63 | $562.34 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $776.25 Typical High $7,943.28 | Facility | None | $549.54 | $776.25 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $645.65 | Professional | None | $295.12 | $407.38 | $645.65 |
Pacific Source Setting Facility Modifier None Typical Low $323.59 Median $537.03 Typical High $549.54 | Facility | None | $323.59 | $537.03 | $549.54 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,754.23 Typical High $4,168.69 | Facility | None | $537.03 | $2,754.23 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $512.86 Typical High $741.31 | Professional | None | $79.43 | $512.86 | $741.31 |
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 $512.86 Median $549.54 Typical High $707.95 | Professional | None | $512.86 | $549.54 | $707.95 |
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 $363.08 Median $501.19 Typical High $831.76 | Professional | None | $363.08 | $501.19 | $831.76 |
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 $154.88 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $61.66 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $46.77 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $218.78 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $269.15 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $16,982.44 Typical High $19,498.45 | Facility | 50 · Both sides | $12,302.69 | $16,982.44 | $19,498.45 |
Where Oregon sits
The same service costs 7.3 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 $6,269MT $863
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.