How much rates vary
Facilitymedian $1,698 · 10th to 90th $1,047 to $13,183Professionalmedian $1,549 · 10th to 90th $832 to $2,344
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 $1,513.56 Median $7,943.28 Typical High $17,378.01 | Facility | None | $1,513.56 | $7,943.28 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,479.11 | Professional | None | $776.25 | $1,230.27 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $8,912.51 Typical High $12,302.69 | Facility | None | $1,000.00 | $8,912.51 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $2,454.71 | Professional | None | $912.01 | $1,445.44 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,819.70 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $7,943.28 Typical High $22,908.68 | Facility | None | $1,513.56 | $7,943.28 | $22,908.68 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $2,041.74 | Professional | None | $870.96 | $1,348.96 | $2,041.74 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $1,778.28 | Facility | None | $1,000.00 | $1,621.81 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $1,047.13 Median $8,317.64 Typical High $12,302.69 | Facility | None | $1,047.13 | $8,317.64 | $12,302.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $2,454.71 | Professional | None | $79.43 | $1,584.89 | $2,454.71 |
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 $1,698.24 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,778.28 | $2,344.23 |
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 $1,047.13 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,548.82 | $2,570.40 |
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 $501.19 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $933.25 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
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 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.