How much rates vary
Facilitymedian $1,148 · 10th to 90th $708 to $12,303Professionalmedian $871 · 10th to 90th $603 to $1,445
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 $489.78 Median $602.56 Typical High $870.96 | Professional | None | $489.78 | $602.56 | $870.96 |
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 $602.56 Median $870.96 Typical High $1,445.44 | Professional | None | $602.56 | $870.96 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,513.56 | Professional | None | $794.33 | $1,071.52 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $1,230.27 Typical High $13,182.57 | Facility | None | $851.14 | $1,230.27 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,230.27 | Professional | None | $602.56 | $870.96 | $1,230.27 |
Pacific Source Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,202.26 | Facility | None | $676.08 | $1,096.48 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $5,370.32 Typical High $11,748.98 | Facility | None | $851.14 | $5,370.32 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $891.25 Typical High $1,445.44 | Professional | None | $79.43 | $891.25 | $1,445.44 |
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 $812.83 Median $1,148.15 Typical High $1,230.27 | Professional | None | $812.83 | $1,148.15 | $1,230.27 |
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 $616.60 Median $954.99 Typical High $1,548.82 | Professional | None | $616.60 | $954.99 | $1,548.82 |
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 $295.12 Median $302.00 Typical High $436.52 | Professional | 52 · Reduced service | $295.12 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $173.78 | Professional | 53 · Discontinued | $120.23 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $446.68 | $446.68 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $87.10 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $302.00 Typical High $436.52 | Professional | 52 · Reduced service | $302.00 | $302.00 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $173.78 | Professional | 53 · Discontinued | $120.23 | $120.23 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $446.68 | $446.68 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $87.10 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $616.60 |
Where Oregon sits
The same service costs 9.2 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 $13,499MT $1,470
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.