How much rates vary
Facilitymedian $1,738 · 10th to 90th $1,047 to $10,000Professionalmedian $1,622 · 10th to 90th $891 to $2,455
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 $8,912.51 Typical High $18,620.87 | Facility | None | $5,128.61 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $891.25 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $6,918.31 Typical High $9,549.93 | Facility | None | $1,230.27 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,513.56 Typical High $2,511.89 | Professional | None | $954.99 | $1,513.56 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,862.09 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $18,620.87 | Facility | None | $1,380.38 | $2,187.76 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,380.38 | $2,041.74 |
Pacific Source Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,778.28 | Facility | None | $1,023.29 | $1,698.24 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $1,230.27 Median $6,309.57 Typical High $9,549.93 | Facility | None | $1,230.27 | $6,309.57 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,659.59 Typical High $2,511.89 | Professional | None | $79.43 | $1,659.59 | $2,511.89 |
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 $1,737.80 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,819.70 | $2,344.23 |
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 $1,096.48 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,621.81 | $2,630.27 |
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 $512.86 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $933.25 | $933.25 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $870.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $26,915.35 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $26,915.35 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 5.0 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 $14,413MT $2,858
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.