How much rates vary
Facilitymedian $1,738 · 10th to 90th $1,202 to $15,488Professionalmedian $1,622 · 10th to 90th $832 to $2,570
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 $1,288.25 Median $15,488.17 Typical High $33,884.42 | Facility | None | $1,288.25 | $15,488.17 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,288.25 | Professional | None | $831.76 | $1,047.13 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $5,754.40 Typical High $7,762.47 | Facility | None | $2,398.83 | $5,754.40 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,584.89 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,737.80 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $1,288.25 Median $11,748.98 Typical High $23,988.33 | Facility | None | $1,288.25 | $11,748.98 | $23,988.33 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,344.23 | Professional | None | $912.01 | $1,288.25 | $2,344.23 |
Pacific Source Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $1,819.70 | Facility | None | $1,047.13 | $1,737.80 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $1,737.80 Median $5,248.07 Typical High $7,762.47 | Facility | None | $1,737.80 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,698.24 Typical High $2,630.27 | Professional | None | $79.43 | $1,698.24 | $2,630.27 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $19,952.62 Typical High $22,908.68 | Facility | None | $14,454.40 | $19,952.62 | $22,908.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,737.80 | $1,819.70 | $2,691.53 |
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 $1,318.26 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,862.09 | $3,162.28 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Where Oregon sits
The same service costs 4.2 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 $11,551MT $2,762
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.