How much rates vary
Facilitymedian $871 · 10th to 90th $537 to $6,026Professionalmedian $603 · 10th to 90th $269 to $1,175
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $524.81 Typical High $660.69 | Professional | None | $269.15 | $524.81 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,019.95 Typical High $4,168.69 | Facility | None | $891.25 | $3,019.95 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $1,202.26 | Professional | None | $302.00 | $602.56 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $1,071.52 | Professional | None | $371.54 | $537.03 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $1,096.48 Typical High $8,709.64 | Facility | None | $389.05 | $1,096.48 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $660.69 Typical High $1,258.93 | Professional | None | $269.15 | $660.69 | $1,258.93 |
Pacific Source Setting Facility Modifier None Typical Low $537.03 Median $794.33 Typical High $933.25 | Facility | None | $537.03 | $794.33 | $933.25 |
Providence Setting Facility Modifier None Typical Low $489.78 Median $2,454.71 Typical High $4,168.69 | Facility | None | $489.78 | $2,454.71 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $549.54 Typical High $1,174.90 | Professional | None | $79.43 | $549.54 | $1,174.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,317.64 Median $10,964.78 Typical High $12,882.50 | Facility | None | $8,317.64 | $10,964.78 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $1,258.93 | Professional | None | $389.05 | $691.83 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,318.26 | Professional | None | $363.08 | $691.83 | $1,318.26 |
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 $134.90 Median $162.18 Typical High $331.13 | Professional | 52 · Reduced service | $134.90 | $162.18 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $64.57 Typical High $131.83 | Professional | 53 · Discontinued | $53.70 | $64.57 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $239.88 Typical High $489.78 | Professional | 54 · Surgery only | $204.17 | $239.88 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $47.86 Typical High $97.72 | Professional | 55 · Aftercare only | $40.74 | $47.86 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $66.07 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $223.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $190.55 | $223.87 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $331.13 | Professional | 52 · Reduced service | $134.90 | $134.90 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $131.83 | Professional | 53 · Discontinued | $53.70 | $53.70 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $489.78 | Professional | 54 · Surgery only | $204.17 | $204.17 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $97.72 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $66.07 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $457.09 |
Where Oregon sits
The same service costs 7.2 times more in Colorado than in North Dakota. 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 $7,086ND $980
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.