How much rates vary
Facilitymedian $1,445 · 10th to 90th $1,000 to $11,749Professionalmedian $1,349 · 10th to 90th $741 to $2,042
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 $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | None | $794.33 | $1,071.52 | $1,071.52 |
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 $776.25 Median $1,230.27 Typical High $2,041.74 | Professional | None | $776.25 | $1,230.27 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,513.56 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $17,378.01 | Facility | None | $1,174.90 | $2,089.30 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,148.15 | $1,737.80 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $1,513.56 | Facility | None | $891.25 | $1,445.44 | $1,513.56 |
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 $1,380.38 Typical High $2,089.30 | Professional | None | $79.43 | $1,380.38 | $2,089.30 |
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 $1,445.44 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,513.56 | $1,995.26 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,238.72 | Professional | None | $912.01 | $1,380.38 | $2,238.72 |
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 $436.52 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $436.52 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $87.10 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
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 6.0 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 $14,230MT $2,377
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.