How much rates vary
Facilitymedian $851 · 10th to 90th $479 to $4,786Professionalmedian $427 · 10th to 90th $191 to $1,047
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 $194.98 Median $436.52 Typical High $707.95 | Professional | None | $194.98 | $436.52 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $3,630.78 | Facility | None | $660.69 | $2,691.53 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $1,122.02 | Professional | None | $190.55 | $436.52 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $1,148.15 | Professional | None | $229.09 | $354.81 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $831.76 Typical High $6,606.93 | Facility | None | $275.42 | $831.76 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $489.78 Typical High $933.25 | Professional | None | $194.98 | $489.78 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $478.63 Median $794.33 Typical High $891.25 | Facility | None | $478.63 | $794.33 | $891.25 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $2,187.76 Typical High $3,630.78 | Facility | None | $323.59 | $2,187.76 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $380.19 Typical High $1,122.02 | Professional | None | $79.43 | $380.19 | $1,122.02 |
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 $251.19 Median $707.95 Typical High $891.25 | Professional | None | $251.19 | $707.95 | $891.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $213.80 Median $446.68 Typical High $1,174.90 | Professional | None | $213.80 | $446.68 | $1,174.90 |
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 $95.50 Median $199.53 Typical High $354.81 | Professional | 52 · Reduced service | $95.50 | $199.53 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $79.43 Typical High $141.25 | Professional | 53 · Discontinued | $38.90 | $79.43 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $302.00 Typical High $524.81 | Professional | 54 · Surgery only | $144.54 | $302.00 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $60.26 Typical High $104.71 | Professional | 55 · Aftercare only | $28.84 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $39.81 Typical High $70.79 | Professional | 56 · Pre-op care only | $19.50 | $39.81 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $281.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $134.90 | $281.84 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $199.53 Typical High $354.81 | Professional | 52 · Reduced service | $95.50 | $199.53 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $79.43 Typical High $141.25 | Professional | 53 · Discontinued | $38.90 | $79.43 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $302.00 Typical High $524.81 | Professional | 54 · Surgery only | $144.54 | $302.00 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $60.26 Typical High $104.71 | Professional | 55 · Aftercare only | $28.84 | $60.26 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $39.81 Typical High $70.79 | Professional | 56 · Pre-op care only | $19.50 | $39.81 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $281.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $134.90 | $281.84 | $489.78 |
Where Oregon sits
The same service costs 5.6 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 $4,763ND $853
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.