How much rates vary
Facilitymedian $1,047 · 10th to 90th $603 to $5,012Professionalmedian $550 · 10th to 90th $269 to $1,318
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 $331.13 Median $4,786.30 Typical High $7,943.28 | Facility | None | $331.13 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $467.74 Typical High $891.25 | Professional | None | $190.55 | $467.74 | $891.25 |
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 $269.15 Median $602.56 Typical High $1,380.38 | Professional | None | $269.15 | $602.56 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $1,548.82 | Professional | None | $323.59 | $512.86 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $1,288.25 Typical High $6,606.93 | Facility | None | $331.13 | $1,288.25 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $588.84 Typical High $1,148.15 | Professional | None | $269.15 | $588.84 | $1,148.15 |
Pacific Source Setting Facility Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,122.02 | Facility | None | $616.60 | $1,023.29 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $2,187.76 Typical High $3,630.78 | Facility | None | $436.52 | $2,187.76 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $1,380.38 | Professional | None | $79.43 | $537.03 | $1,380.38 |
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 $346.74 Median $851.14 Typical High $1,122.02 | Professional | None | $346.74 | $851.14 | $1,122.02 |
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 $302.00 Median $630.96 Typical High $1,445.44 | Professional | None | $302.00 | $630.96 | $1,445.44 |
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 $134.90 Median $257.04 Typical High $446.68 | Professional | 52 · Reduced service | $134.90 | $257.04 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $102.33 Typical High $181.97 | Professional | 53 · Discontinued | $54.95 | $102.33 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $380.19 Typical High $676.08 | Professional | 54 · Surgery only | $204.17 | $380.19 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $75.86 Typical High $134.90 | Professional | 55 · Aftercare only | $40.74 | $75.86 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $51.29 Typical High $89.13 | Professional | 56 · Pre-op care only | $26.92 | $51.29 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $354.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $190.55 | $354.81 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $257.04 Typical High $446.68 | Professional | 52 · Reduced service | $134.90 | $257.04 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $102.33 Typical High $181.97 | Professional | 53 · Discontinued | $54.95 | $102.33 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $380.19 Typical High $676.08 | Professional | 54 · Surgery only | $204.17 | $380.19 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $75.86 Typical High $134.90 | Professional | 55 · Aftercare only | $40.74 | $75.86 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $51.29 Typical High $89.13 | Professional | 56 · Pre-op care only | $26.92 | $51.29 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $354.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $190.55 | $354.81 | $630.96 |
Where Oregon sits
The same service costs 4.4 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 $4,844ND $1,099
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.