How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,445 to $10,000Professionalmedian $2,188 · 10th to 90th $1,202 to $3,311
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 $1,949.84 Median $10,232.93 Typical High $24,547.09 | Facility | None | $1,949.84 | $10,232.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,479.11 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $2,630.27 Median $6,918.31 Typical High $9,549.93 | Facility | None | $2,630.27 | $6,918.31 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,949.84 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,570.40 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $19,952.62 | Facility | None | $1,584.89 | $2,818.38 | $19,952.62 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,584.89 | $1,905.46 | $2,754.23 |
Pacific Source Setting Facility Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $2,454.71 | Facility | None | $1,380.38 | $2,290.87 | $2,454.71 |
Providence Setting Facility Modifier None Typical Low $2,137.96 Median $6,456.54 Typical High $9,549.93 | Facility | None | $2,137.96 | $6,456.54 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,187.76 Typical High $3,311.31 | Professional | None | $79.43 | $2,187.76 | $3,311.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $17,782.79 Median $25,118.86 Typical High $28,183.83 | Facility | None | $17,782.79 | $25,118.86 | $28,183.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,344.23 Median $2,454.71 Typical High $3,162.28 | Professional | None | $2,344.23 | $2,454.71 | $3,162.28 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,380.38 | $2,137.96 | $3,548.13 |
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 $691.83 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,096.48 |
Where Oregon sits
The same service costs 5.5 times more in Colorado than in West Virginia. 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 $14,842WV $2,709
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.