How much rates vary
Facilitymedian $1,122 · 10th to 90th $661 to $6,026Professionalmedian $832 · 10th to 90th $490 to $1,318
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 $660.69 Median $5,128.61 Typical High $8,709.64 | Facility | None | $660.69 | $5,128.61 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $831.76 | Professional | None | $380.19 | $549.54 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $4,168.69 | Facility | None | $891.25 | $3,090.30 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,412.54 | Professional | None | $575.44 | $851.14 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,479.11 | Professional | None | $758.58 | $1,023.29 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,318.26 Typical High $8,709.64 | Facility | None | $660.69 | $1,318.26 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,202.26 | Professional | None | $467.74 | $758.58 | $1,202.26 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,148.15 | Facility | None | $660.69 | $1,071.52 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $2,511.89 Typical High $4,168.69 | Facility | None | $776.25 | $2,511.89 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $851.14 Typical High $1,412.54 | Professional | None | $79.43 | $851.14 | $1,412.54 |
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 $758.58 Median $1,096.48 Typical High $1,174.90 | Professional | None | $758.58 | $1,096.48 | $1,174.90 |
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 $562.34 Median $891.25 Typical High $1,479.11 | Professional | None | $562.34 | $891.25 | $1,479.11 |
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 $269.15 Median $269.15 Typical High $416.87 | Professional | 52 · Reduced service | $269.15 | $269.15 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $165.96 | Professional | 53 · Discontinued | $109.65 | $109.65 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $630.96 | Professional | 54 · Surgery only | $407.38 | $407.38 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $125.89 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $83.18 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $416.87 | Professional | 52 · Reduced service | $269.15 | $269.15 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $165.96 | Professional | 53 · Discontinued | $109.65 | $109.65 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $630.96 | Professional | 54 · Surgery only | $407.38 | $407.38 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $125.89 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $83.18 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $588.84 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $16,982.44 Typical High $19,498.45 | Facility | 50 · Both sides | $12,302.69 | $16,982.44 | $19,498.45 |
Where Oregon sits
The same service costs 4.3 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 $6,199MT $1,425
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.