How much rates vary
Facilitymedian $1,122 · 10th to 90th $741 to $5,129Professionalmedian $813 · 10th to 90th $501 to $1,318
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 $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $812.83 | Professional | None | $407.38 | $512.86 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $4,168.69 | Facility | None | $891.25 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,348.96 | Professional | None | $501.19 | $776.25 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,348.96 | Professional | None | $645.65 | $891.25 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $1,230.27 Typical High $7,943.28 | Facility | None | $724.44 | $1,230.27 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,122.02 | Professional | None | $501.19 | $812.83 | $1,122.02 |
Pacific Source Setting Facility Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,230.27 | Facility | None | $741.31 | $1,023.29 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $2,187.76 Typical High $4,073.80 | Facility | None | $707.95 | $2,187.76 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $794.33 Typical High $1,348.96 | Professional | None | $79.43 | $794.33 | $1,348.96 |
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 $660.69 Median $977.24 Typical High $1,071.52 | Professional | None | $660.69 | $977.24 | $1,071.52 |
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 $933.25 Typical High $1,445.44 | Professional | None | $575.44 | $933.25 | $1,445.44 |
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 $251.19 Median $251.19 Typical High $407.38 | Professional | 52 · Reduced service | $251.19 | $251.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | 53 · Discontinued | $100.00 | $100.00 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $616.60 | Professional | 54 · Surgery only | $380.19 | $380.19 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $123.03 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $407.38 | Professional | 52 · Reduced service | $251.19 | $251.19 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $162.18 | Professional | 53 · Discontinued | $100.00 | $100.00 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $616.60 | Professional | 54 · Surgery only | $380.19 | $380.19 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $123.03 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $575.44 |
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 4.4 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 $6,451MT $1,460
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.