How much rates vary
Facilitymedian $724 · 10th to 90th $513 to $5,888Professionalmedian $661 · 10th to 90th $347 to $1,023
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 $346.74 Median $524.81 Typical High $549.54 | Professional | None | $346.74 | $524.81 | $549.54 |
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 $501.19 Median $660.69 Typical High $1,023.29 | Professional | None | $501.19 | $660.69 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $891.25 | Professional | None | $630.96 | $741.31 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $977.24 Typical High $7,943.28 | Facility | None | $676.08 | $977.24 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $933.25 | Professional | None | $380.19 | $537.03 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $416.87 Median $691.83 Typical High $741.31 | Facility | None | $416.87 | $691.83 | $741.31 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $4,365.16 | Facility | None | $549.54 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $676.08 Typical High $1,071.52 | Professional | None | $79.43 | $676.08 | $1,071.52 |
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 $707.95 Median $741.31 Typical High $1,096.48 | Professional | None | $707.95 | $741.31 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,288.25 | Professional | None | $537.03 | $758.58 | $1,288.25 |
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 $239.88 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $363.08 |
Where Oregon sits
The same service costs 5.9 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 $6,847MT $1,164
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.