How much rates vary
Facilitymedian $977 · 10th to 90th $589 to $7,943Professionalmedian $724 · 10th to 90th $447 to $1,148
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 $776.25 Median $5,128.61 Typical High $17,378.01 | Facility | None | $776.25 | $5,128.61 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $724.44 | Professional | None | $331.13 | $457.09 | $724.44 |
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 $489.78 Median $741.31 Typical High $1,202.26 | Professional | None | $489.78 | $741.31 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,288.25 | Professional | None | $630.96 | $851.14 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,230.27 Typical High $11,220.18 | Facility | None | $660.69 | $1,230.27 | $11,220.18 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,023.29 | Professional | None | $446.68 | $691.83 | $1,023.29 |
Pacific Source Setting Facility Modifier None Typical Low $575.44 Median $912.01 Typical High $1,000.00 | Facility | None | $575.44 | $912.01 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,511.89 Typical High $4,168.69 | Facility | None | $660.69 | $2,511.89 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $741.31 Typical High $1,202.26 | Professional | None | $79.43 | $741.31 | $1,202.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $11,481.54 Typical High $12,882.50 | Facility | None | $8,128.31 | $11,481.54 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,000.00 | Professional | None | $630.96 | $933.25 | $1,000.00 |
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 $478.63 Median $776.25 Typical High $1,288.25 | Professional | None | $478.63 | $776.25 | $1,288.25 |
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 $229.09 Median $229.09 Typical High $363.08 | Professional | 52 · Reduced service | $229.09 | $229.09 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $144.54 | Professional | 53 · Discontinued | $91.20 | $91.20 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $537.03 | Professional | 54 · Surgery only | $346.74 | $346.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $109.65 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $72.44 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $229.09 Typical High $363.08 | Professional | 52 · Reduced service | $229.09 | $229.09 | $363.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $144.54 | Professional | 53 · Discontinued | $91.20 | $91.20 | $144.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $537.03 | Professional | 54 · Surgery only | $346.74 | $346.74 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $109.65 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $72.44 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $72.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $501.19 |
Where Oregon sits
The same service costs 6.4 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 $6,390WV $1,003
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.