How much rates vary
Facilitymedian $646 · 10th to 90th $389 to $5,129Professionalmedian $575 · 10th to 90th $269 to $933
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $524.81 Typical High $524.81 | Professional | None | $245.47 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,691.53 Typical High $3,630.78 | Facility | None | $870.96 | $2,691.53 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $954.99 | Professional | None | $363.08 | $562.34 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $933.25 | Professional | None | $616.60 | $758.58 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $7,943.28 | Facility | None | $524.81 | $758.58 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $812.83 | Professional | None | $316.23 | $524.81 | $812.83 |
Pacific Source Setting Facility Modifier None Typical Low $363.08 Median $588.84 Typical High $691.83 | Facility | None | $363.08 | $588.84 | $691.83 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $2,344.23 Typical High $3,388.44 | Facility | None | $549.54 | $2,344.23 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $562.34 Typical High $954.99 | Professional | None | $79.43 | $562.34 | $954.99 |
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 $630.96 Median $691.83 Typical High $912.01 | Professional | None | $630.96 | $691.83 | $912.01 |
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 $380.19 Median $588.84 Typical High $1,000.00 | Professional | None | $380.19 | $588.84 | $1,000.00 |
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 $177.83 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $177.83 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $70.79 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $263.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $52.48 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $35.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $245.47 | $371.54 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $245.47 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $363.08 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $371.54 |
Where Oregon sits
The same service costs 5.5 times more in Colorado than in Michigan. 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 $4,792MI $877
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.