How much rates vary
Facilitymedian $417 · 10th to 90th $282 to $5,129Professionalmedian $389 · 10th to 90th $219 to $603
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 $218.78 Median $302.00 Typical High $309.03 | Professional | None | $218.78 | $302.00 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,235.94 Typical High $4,365.16 | Facility | None | $660.69 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $575.44 | Professional | None | $288.40 | $380.19 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $501.19 | Professional | None | $363.08 | $416.87 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $7,943.28 | Facility | None | $338.84 | $562.34 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $549.54 | Professional | None | $239.88 | $309.03 | $549.54 |
Pacific Source Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $416.87 | Facility | None | $245.47 | $398.11 | $416.87 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $2,884.03 Typical High $4,365.16 | Facility | None | $436.52 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $389.05 Typical High $616.60 | Professional | None | $79.43 | $389.05 | $616.60 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $12,022.64 Typical High $13,803.84 | Facility | None | $8,912.51 | $12,022.64 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $630.96 | Professional | None | $398.11 | $416.87 | $630.96 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $724.44 | Professional | None | $309.03 | $436.52 | $724.44 |
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 $141.25 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $208.93 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $223.87 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $208.93 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $13,489.63 Median $18,197.01 Typical High $20,892.96 | Facility | 50 · Both sides | $13,489.63 | $18,197.01 | $20,892.96 |
Where Oregon sits
The same service costs 9.6 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 $6,197MT $647
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.