How much rates vary
Facilitymedian $550 · 10th to 90th $316 to $6,918Professionalmedian $407 · 10th to 90th $229 to $661
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 $363.08 Median $6,918.31 Typical High $17,378.01 | Facility | None | $363.08 | $6,918.31 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $446.68 | Professional | None | $204.17 | $263.03 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,691.53 Typical High $3,630.78 | Facility | None | $1,000.00 | $2,691.53 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $707.95 | Professional | None | $229.09 | $407.38 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $758.58 | Professional | None | $281.84 | $426.58 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $645.65 Typical High $12,022.64 | Facility | None | $309.03 | $645.65 | $12,022.64 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $602.56 | Professional | None | $234.42 | $363.08 | $602.56 |
Pacific Source Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $575.44 | Facility | None | $309.03 | $478.63 | $575.44 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $2,187.76 Typical High $3,630.78 | Facility | None | $380.19 | $2,187.76 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $724.44 | Professional | None | $79.43 | $398.11 | $724.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $9,549.93 Typical High $10,964.78 | Facility | None | $6,918.31 | $9,549.93 | $10,964.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $575.44 | Professional | None | $302.00 | $512.86 | $575.44 |
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 $257.04 Median $426.58 Typical High $741.31 | Professional | None | $257.04 | $426.58 | $741.31 |
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 $117.49 Median $125.89 Typical High $223.87 | Professional | 52 · Reduced service | $117.49 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $89.13 | Professional | 53 · Discontinued | $47.86 | $50.12 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $190.55 Typical High $338.84 | Professional | 54 · Surgery only | $177.83 | $190.55 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.02 Typical High $67.61 | Professional | 55 · Aftercare only | $35.48 | $38.02 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $44.67 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $177.83 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $165.96 | $177.83 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $125.89 Typical High $223.87 | Professional | 52 · Reduced service | $117.49 | $125.89 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $89.13 | Professional | 53 · Discontinued | $47.86 | $50.12 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $186.21 Typical High $338.84 | Professional | 54 · Surgery only | $177.83 | $186.21 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $67.61 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $44.67 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $44.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $173.78 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $165.96 | $173.78 | $316.23 |
Where Oregon sits
The same service costs 8.5 times more in Colorado than in West Virginia. 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 $4,660WV $549
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.