How much rates vary
Facilitymedian $1,660 · 10th to 90th $1,047 to $12,882Professionalmedian $1,380 · 10th to 90th $724 to $2,089
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 $1,380.38 Median $8,912.51 Typical High $18,620.87 | Facility | None | $1,380.38 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,122.02 | Professional | None | $954.99 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $9,332.54 Typical High $12,882.50 | Facility | None | $870.96 | $9,332.54 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,288.25 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,348.96 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $6,309.57 Typical High $18,620.87 | Facility | None | $1,230.27 | $6,309.57 | $18,620.87 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,862.09 | Professional | None | $977.24 | $1,122.02 | $1,862.09 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,737.80 | Facility | None | $1,000.00 | $1,348.96 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $8,317.64 Typical High $12,022.64 | Facility | None | $912.01 | $8,317.64 | $12,022.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,412.54 Typical High $2,041.74 | Professional | None | $79.43 | $1,412.54 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $23,988.33 Median $32,359.37 Typical High $37,153.52 | Facility | None | $23,988.33 | $32,359.37 | $37,153.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,380.38 | $2,089.30 |
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 $1,258.93 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,737.80 | $2,398.83 |
13 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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $36,307.81 Median $48,977.88 Typical High $54,954.09 | Facility | 50 · Both sides | $36,307.81 | $48,977.88 | $54,954.09 |
Where Oregon sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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 $14,612KY $2,222
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.