How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,445 to $13,804Professionalmedian $1,905 · 10th to 90th $977 to $2,951
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 $1,862.09 Median $7,943.28 Typical High $19,952.62 | Facility | None | $1,862.09 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $1,862.09 | Professional | None | $977.24 | $1,513.56 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $6,918.31 Typical High $9,549.93 | Facility | None | $1,412.54 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,122.02 | $1,778.28 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,630.27 | Professional | None | $1,819.70 | $2,137.96 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $1,862.09 Median $8,912.51 Typical High $19,952.62 | Facility | None | $1,862.09 | $8,912.51 | $19,952.62 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,659.59 Typical High $3,467.37 | Professional | None | $933.25 | $1,659.59 | $3,467.37 |
Pacific Source Setting Facility Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $2,137.96 | Facility | None | $1,230.27 | $2,041.74 | $2,137.96 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $6,309.57 Typical High $9,549.93 | Facility | None | $1,412.54 | $6,309.57 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,995.26 Typical High $2,951.21 | Professional | None | $79.43 | $1,995.26 | $2,951.21 |
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 $2,041.74 Median $2,187.76 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,187.76 | $2,818.38 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,128.61 Typical High $25,118.86 | Facility | None | $2,691.53 | $5,128.61 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,905.46 | $3,162.28 |
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 $616.60 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $851.14 | $1,047.13 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,047.13 |
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 4.2 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 $14,362MT $3,396
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.