How much rates vary
Facilitymedian $1,000 · 10th to 90th $617 to $5,754Professionalmedian $912 · 10th to 90th $490 to $1,413
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | None | $537.03 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $3,801.89 | Facility | None | $1,000.00 | $2,754.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,412.54 | Professional | None | $602.56 | $831.76 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,202.26 | Professional | None | $758.58 | $933.25 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $1,445.44 Typical High $17,378.01 | Facility | None | $851.14 | $1,445.44 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,230.27 | Professional | None | $741.31 | $776.25 | $1,230.27 |
Pacific Source Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $1,023.29 | Facility | None | $588.84 | $977.24 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $2,511.89 Typical High $3,801.89 | Facility | None | $831.76 | $2,511.89 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $933.25 Typical High $1,513.56 | Professional | None | $79.43 | $933.25 | $1,513.56 |
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 $977.24 Median $1,023.29 Typical High $1,380.38 | Professional | None | $977.24 | $1,023.29 | $1,380.38 |
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 $741.31 Median $912.01 Typical High $1,548.82 | Professional | None | $741.31 | $912.01 | $1,548.82 |
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 $281.84 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $281.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $114.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $426.58 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $85.11 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $56.23 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $398.11 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $346.74 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $141.25 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $524.81 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $537.03 |
Where Oregon sits
The same service costs 3.9 times more in Colorado than in Delaware. 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 $5,057DE $1,284
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.