How much rates vary
Facilitymedian $1,445 · 10th to 90th $871 to $6,026Professionalmedian $589 · 10th to 90th $219 to $2,042
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 $302.00 Median $5,623.41 Typical High $8,709.64 | Facility | None | $302.00 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $707.95 Typical High $1,318.26 | Professional | None | $181.97 | $707.95 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,801.89 Typical High $5,248.07 | Facility | None | $891.25 | $3,801.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $602.56 Typical High $2,187.76 | Professional | None | $275.42 | $602.56 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $1,905.46 | Professional | None | $323.59 | $478.63 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $7,943.28 | Facility | None | $302.00 | $1,698.24 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $707.95 Typical High $1,479.11 | Professional | None | $213.80 | $707.95 | $1,479.11 |
Pacific Source Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,548.82 | Facility | None | $912.01 | $1,348.96 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $3,090.30 Typical High $5,248.07 | Facility | None | $436.52 | $3,090.30 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $2,137.96 | Professional | None | $79.43 | $489.78 | $2,137.96 |
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 $346.74 Median $616.60 Typical High $2,290.87 | Professional | None | $346.74 | $616.60 | $2,290.87 |
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 $331.13 Median $870.96 Typical High $2,290.87 | Professional | None | $331.13 | $870.96 | $2,290.87 |
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 $123.03 Median $147.91 Typical High $602.56 | Professional | 52 · Reduced service | $123.03 | $147.91 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $60.26 Typical High $239.88 | Professional | 53 · Discontinued | $48.98 | $60.26 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $223.87 Typical High $891.25 | Professional | 54 · Surgery only | $186.21 | $223.87 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $177.83 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $120.23 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $208.93 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $173.78 | $208.93 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $123.03 Typical High $602.56 | Professional | 52 · Reduced service | $123.03 | $123.03 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $239.88 | Professional | 53 · Discontinued | $48.98 | $48.98 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $891.25 | Professional | 54 · Surgery only | $186.21 | $186.21 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $177.83 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $120.23 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $831.76 |
Where Oregon sits
The same service costs 5.1 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 $7,315MT $1,443
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.