How much rates vary
Facilitymedian $1,230 · 10th to 90th $871 to $8,318Professionalmedian $1,148 · 10th to 90th $603 to $1,738
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 $645.65 Median $954.99 Typical High $954.99 | Professional | None | $645.65 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,258.93 | $5,623.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,737.80 | Professional | None | $758.58 | $1,047.13 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,258.93 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $17,378.01 | Facility | None | $1,047.13 | $1,778.28 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,548.82 | Professional | None | $812.83 | $977.24 | $1,548.82 |
Pacific Source Setting Facility Modifier None Typical Low $741.31 Median $1,230.27 Typical High $1,288.25 | Facility | None | $741.31 | $1,230.27 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $1,071.52 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,071.52 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,174.90 Typical High $1,905.46 | Professional | None | $79.43 | $1,174.90 | $1,905.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $19,952.62 Typical High $22,908.68 | Facility | None | $14,454.40 | $19,952.62 | $22,908.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,288.25 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,995.26 | Professional | None | $933.25 | $1,174.90 | $1,995.26 |
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 $346.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $346.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $512.86 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $102.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $69.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $478.63 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $707.95 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $660.69 | $660.69 |
Where Oregon sits
The same service costs 5.4 times more in Colorado than in Montana. 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 $11,084MT $2,070
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.