How much rates vary
Facilitymedian $427 · 10th to 90th $234 to $4,898Professionalmedian $316 · 10th to 90th $182 to $501
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $331.13 | Professional | None | $131.83 | $194.98 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,754.23 Typical High $3,801.89 | Facility | None | $660.69 | $2,754.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $549.54 | Professional | None | $186.21 | $323.59 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $537.03 | Professional | None | $213.80 | $316.23 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $478.63 Typical High $6,606.93 | Facility | None | $245.47 | $478.63 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $426.58 | Professional | None | $181.97 | $288.40 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $436.52 | Facility | None | $229.09 | $371.54 | $436.52 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $2,238.72 Typical High $3,801.89 | Facility | None | $275.42 | $2,238.72 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $549.54 | Professional | None | $79.43 | $316.23 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,964.78 Typical High $12,882.50 | Facility | None | $7,413.10 | $10,964.78 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $436.52 | Professional | None | $239.88 | $398.11 | $436.52 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $562.34 | Professional | None | $190.55 | $323.59 | $562.34 |
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 $91.20 Median $100.00 Typical High $165.96 | Professional | 52 · Reduced service | $91.20 | $100.00 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $40.74 Typical High $66.07 | Professional | 53 · Discontinued | $36.31 | $40.74 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $251.19 | Professional | 54 · Surgery only | $134.90 | $151.36 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $50.12 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $33.11 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $100.00 Typical High $165.96 | Professional | 52 · Reduced service | $91.20 | $100.00 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $40.74 Typical High $66.07 | Professional | 53 · Discontinued | $36.31 | $40.74 | $66.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $251.19 | Professional | 54 · Surgery only | $134.90 | $151.36 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $50.12 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $33.11 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $33.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $234.42 |
Where Oregon sits
The same service costs 9.8 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 $4,589ND $469
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.