How much rates vary
Facilitymedian $275 · 10th to 90th $162 to $4,266Professionalmedian $229 · 10th to 90th $138 to $389
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 $138.04 Median $141.25 Typical High $208.93 | Professional | None | $138.04 | $141.25 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,089.30 Typical High $2,884.03 | Facility | None | $660.69 | $2,089.30 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $398.11 | Professional | None | $144.54 | $234.42 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $346.74 | Professional | None | $177.83 | $245.47 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $6,606.93 | Facility | None | $199.53 | $302.00 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $309.03 | Professional | None | $138.04 | $208.93 | $309.03 |
Pacific Source Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $281.84 | Facility | None | $158.49 | $257.04 | $281.84 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $1,698.24 Typical High $2,884.03 | Facility | None | $218.78 | $1,698.24 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $389.05 | Professional | None | $79.43 | $234.42 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $7,413.10 | Facility | None | $4,786.30 | $6,456.54 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $380.19 | Professional | None | $190.55 | $275.42 | $380.19 |
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 $158.49 Median $251.19 Typical High $407.38 | Professional | None | $158.49 | $251.19 | $407.38 |
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 $69.18 Median $69.18 Typical High $104.71 | Professional | 52 · Reduced service | $69.18 | $69.18 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $41.69 | Professional | 53 · Discontinued | $27.54 | $27.54 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | 54 · Surgery only | $102.33 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $30.90 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $104.71 | Professional | 52 · Reduced service | $69.18 | $69.18 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $41.69 | Professional | 53 · Discontinued | $27.54 | $27.54 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | 54 · Surgery only | $102.33 | $102.33 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $30.90 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $20.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $95.50 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $95.50 | $95.50 | $144.54 |
Where Oregon sits
The same service costs 13.0 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 $4,547MT $350
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.