How much rates vary
Facilitymedian $794 · 10th to 90th $479 to $5,129Professionalmedian $603 · 10th to 90th $372 to $955
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 $354.81 Median $371.54 Typical High $602.56 | Professional | None | $354.81 | $371.54 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $4,168.69 | Facility | None | $1,000.00 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,000.00 | Professional | None | $398.11 | $602.56 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,023.29 | Professional | None | $512.86 | $691.83 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $13,182.57 | Facility | None | $537.03 | $851.14 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $851.14 | Professional | None | $371.54 | $602.56 | $851.14 |
Pacific Source Setting Facility Modifier None Typical Low $478.63 Median $776.25 Typical High $812.83 | Facility | None | $478.63 | $776.25 | $812.83 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $2,511.89 Typical High $4,168.69 | Facility | None | $616.60 | $2,511.89 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $602.56 Typical High $1,000.00 | Professional | None | $79.43 | $602.56 | $1,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $11,220.18 Typical High $12,882.50 | Facility | None | $4,570.88 | $11,220.18 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $812.83 | Professional | None | $512.86 | $741.31 | $812.83 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $389.05 Median $630.96 Typical High $1,071.52 | Professional | None | $389.05 | $630.96 | $1,071.52 |
12 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 $186.21 Median $186.21 Typical High $302.00 | Professional | 52 · Reduced service | $186.21 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $120.23 | Professional | 53 · Discontinued | $74.13 | $74.13 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $446.68 | Professional | 54 · Surgery only | $281.84 | $281.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $91.20 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | 52 · Reduced service | $186.21 | $186.21 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $120.23 | Professional | 53 · Discontinued | $74.13 | $74.13 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $446.68 | Professional | 54 · Surgery only | $281.84 | $281.84 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $91.20 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $60.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $416.87 |
Where Oregon sits
The same service costs 6.3 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 $6,296MT $1,002
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.