How much rates vary
Facilitymedian $155 · 10th to 90th $105 to $5,012Professionalmedian $148 · 10th to 90th $81 to $224
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | None | $100.00 | $100.00 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,862.09 Typical High $2,570.40 | Facility | None | $660.69 | $1,862.09 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $218.78 | Professional | None | $109.65 | $144.54 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $186.21 | Professional | None | $134.90 | $154.88 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $213.80 Typical High $7,943.28 | Facility | None | $144.54 | $213.80 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $208.93 | Professional | None | $100.00 | $125.89 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $154.88 | Facility | None | $95.50 | $151.36 | $154.88 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $1,737.80 Typical High $2,570.40 | Facility | None | $173.78 | $1,737.80 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $223.87 | Professional | None | $79.43 | $144.54 | $223.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,079.46 Typical High $8,128.31 | Facility | None | $5,248.07 | $7,079.46 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $229.09 | Professional | None | $147.91 | $154.88 | $229.09 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $269.15 | Professional | None | $114.82 | $169.82 | $269.15 |
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 $50.12 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 54 · Surgery only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 54 · Surgery only | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $70.79 | $70.79 | $70.79 |
Where Oregon sits
The same service costs 18.4 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 $4,483MT $243
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.