How much rates vary
Facilitymedian $4,467 · 10th to 90th $2,188 to $5,129Professionalmedian $4,571 · 10th to 90th $79 to $7,079
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,090.30 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,168.69 Median $4,897.79 Typical High $5,888.44 | Professional | None | $4,168.69 | $4,897.79 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $3,090.30 Median $5,754.40 Typical High $7,943.28 | Facility | None | $3,090.30 | $5,754.40 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,801.89 Typical High $6,456.54 | Professional | None | $2,630.27 | $3,801.89 | $6,456.54 |
Pacific Source Setting Facility Modifier None Typical Low $2,818.38 Median $4,466.84 Typical High $4,897.79 | Facility | None | $2,818.38 | $4,466.84 | $4,897.79 |
Providence Setting Facility Modifier None Typical Low $3,235.94 Median $5,128.61 Typical High $7,079.46 | Facility | None | $3,235.94 | $5,128.61 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,677.35 Typical High $7,079.46 | Professional | None | $79.43 | $4,677.35 | $7,079.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | None | $12,302.69 | $12,302.69 | $12,302.69 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,677.35 Median $4,897.79 Typical High $7,244.36 | Professional | None | $4,677.35 | $4,897.79 | $7,244.36 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $8,511.38 | Professional | None | $3,548.13 | $5,128.61 | $8,511.38 |
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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $2,187.76 |
Where Oregon sits
The same service costs 7.3 times more in Colorado than in Delaware. 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 $22,169DE $3,038
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.