How much rates vary
Facilitymedian $1,072 · 10th to 90th $741 to $10,233Professionalmedian $977 · 10th to 90th $550 to $1,514
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 $501.19 Median $776.25 Typical High $776.25 | Professional | None | $501.19 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,918.31 Typical High $9,549.93 | Facility | None | $1,000.00 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $1,513.56 | Professional | None | $575.44 | $912.01 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,412.54 | Professional | None | $977.24 | $1,148.15 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $17,378.01 | Facility | None | $851.14 | $1,479.11 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,258.93 | Professional | None | $776.25 | $851.14 | $1,258.93 |
Pacific Source Setting Facility Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,122.02 | Facility | None | $630.96 | $1,023.29 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $6,309.57 Typical High $9,549.93 | Facility | None | $831.76 | $6,309.57 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $977.24 Typical High $1,513.56 | Professional | None | $79.43 | $977.24 | $1,513.56 |
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 $1,047.13 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,122.02 | $1,445.44 |
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 $645.65 Median $977.24 Typical High $1,621.81 | Professional | None | $645.65 | $977.24 | $1,621.81 |
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 $309.03 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $575.44 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $537.03 |
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 7.9 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 $13,941MT $1,762
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.