How much rates vary
Facilitymedian $912 · 10th to 90th $575 to $4,571Professionalmedian $676 · 10th to 90th $407 to $1,072
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 $8,317.64 Typical High $17,378.01 | Facility | None | $5,128.61 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $676.08 | Professional | None | $316.23 | $478.63 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,659.59 Typical High $2,238.72 | Facility | None | $954.99 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,148.15 | Professional | None | $457.09 | $691.83 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Professional | None | $588.84 | $812.83 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $977.24 Typical High $13,182.57 | Facility | None | $616.60 | $977.24 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $977.24 | Professional | None | $398.11 | $645.65 | $977.24 |
Pacific Source Setting Facility Modifier None Typical Low $537.03 Median $912.01 Typical High $933.25 | Facility | None | $537.03 | $912.01 | $933.25 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $2,238.72 | Facility | None | $660.69 | $1,412.54 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $691.83 Typical High $1,148.15 | Professional | None | $79.43 | $691.83 | $1,148.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $933.25 | Professional | None | $602.56 | $870.96 | $933.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,202.26 | Professional | None | $457.09 | $724.44 | $1,202.26 |
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 $218.78 Median $218.78 Typical High $338.84 | Professional | 52 · Reduced service | $218.78 | $218.78 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $138.04 | Professional | 53 · Discontinued | $87.10 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $512.86 | Professional | 54 · Surgery only | $323.59 | $323.59 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $102.33 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $218.78 Typical High $338.84 | Professional | 52 · Reduced service | $218.78 | $218.78 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $138.04 | Professional | 53 · Discontinued | $87.10 | $87.10 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $512.86 | Professional | 54 · Surgery only | $323.59 | $323.59 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $102.33 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $478.63 |
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 5.2 times more in Colorado than in West Virginia. 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 $4,833WV $936
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.