How much rates vary
Facilitymedian $1,047 · 10th to 90th $646 to $4,571Professionalmedian $955 · 10th to 90th $589 to $1,479
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 $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $776.25 | Professional | None | $467.74 | $691.83 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,238.72 | Facility | None | $891.25 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,479.11 | Professional | None | $588.84 | $891.25 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,513.56 | Professional | None | $954.99 | $1,202.26 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,288.25 Typical High $8,912.51 | Facility | None | $776.25 | $1,288.25 | $8,912.51 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,230.27 | Professional | None | $691.83 | $812.83 | $1,230.27 |
Pacific Source Setting Facility Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,096.48 | Facility | None | $630.96 | $1,047.13 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,238.72 | Facility | None | $891.25 | $1,445.44 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $954.99 Typical High $1,513.56 | Professional | None | $79.43 | $954.99 | $1,513.56 |
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 $954.99 Median $1,071.52 Typical High $1,380.38 | Professional | None | $954.99 | $1,071.52 | $1,380.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,621.81 | Professional | None | $645.65 | $954.99 | $1,621.81 |
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 $316.23 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $316.23 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $346.74 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $138.04 | $138.04 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $524.81 | $524.81 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $537.03 |
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 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.