How much rates vary
Facilitymedian $389 · 10th to 90th $251 to $4,786Professionalmedian $295 · 10th to 90th $174 to $513
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 $229.09 Median $4,786.30 Typical High $7,943.28 | Facility | None | $229.09 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $316.23 | Professional | None | $134.90 | $199.53 | $316.23 |
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 $194.98 Median $316.23 Typical High $549.54 | Professional | None | $194.98 | $316.23 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $489.78 | Professional | None | $234.42 | $331.13 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $407.38 Typical High $6,606.93 | Facility | None | $229.09 | $407.38 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $407.38 | Professional | None | $165.96 | $245.47 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $346.74 Typical High $389.05 | Facility | None | $218.78 | $346.74 | $389.05 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $2,884.03 | Facility | None | $302.00 | $1,698.24 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $524.81 | Professional | None | $79.43 | $316.23 | $524.81 |
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 $251.19 Median $380.19 Typical High $524.81 | Professional | None | $251.19 | $380.19 | $524.81 |
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 $218.78 Median $338.84 Typical High $562.34 | Professional | None | $218.78 | $338.84 | $562.34 |
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 $93.33 Median $93.33 Typical High $141.25 | Professional | 52 · Reduced service | $93.33 | $93.33 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $57.54 | Professional | 53 · Discontinued | $37.15 | $37.15 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $138.04 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $141.25 | Professional | 52 · Reduced service | $93.33 | $93.33 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $57.54 | Professional | 53 · Discontinued | $37.15 | $37.15 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $138.04 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $28.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $199.53 |
Where Oregon sits
The same service costs 9.9 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 $4,605MT $466
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.