How much rates vary
Facilitymedian $832 · 10th to 90th $501 to $3,236Professionalmedian $776 · 10th to 90th $468 to $1,175
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 $407.38 Median $575.44 Typical High $630.96 | Professional | None | $407.38 | $575.44 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $2,238.72 | Facility | None | $660.69 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,202.26 | Professional | None | $478.63 | $741.31 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,230.27 | Professional | None | $812.83 | $1,023.29 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $6,606.93 | Facility | None | $630.96 | $954.99 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $977.24 | Professional | None | $489.78 | $630.96 | $977.24 |
Pacific Source Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $891.25 | Facility | None | $501.19 | $812.83 | $891.25 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $2,238.72 | Facility | None | $660.69 | $1,318.26 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $794.33 Typical High $1,230.27 | Professional | None | $79.43 | $794.33 | $1,230.27 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,309.57 | Facility | None | $4,073.80 | $5,623.41 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,122.02 | Professional | None | $794.33 | $870.96 | $1,122.02 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,318.26 | Professional | None | $489.78 | $758.58 | $1,318.26 |
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 $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $251.19 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $102.33 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $288.40 | $288.40 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $114.82 | $114.82 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $426.58 | $426.58 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $63.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $436.52 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $6,025.60 Median $8,317.64 Typical High $9,549.93 | Facility | 50 · Both sides | $6,025.60 | $8,317.64 | $9,549.93 |
Where Oregon sits
The same service costs 4.7 times more in Colorado than in Delaware. 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 $4,364DE $926
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.