How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,413 to $10,000Professionalmedian $2,089 · 10th to 90th $1,096 to $3,020
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 $5,128.61 Median $8,317.64 Typical High $17,378.01 | Facility | None | $5,128.61 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,513.56 | $1,659.59 |
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 $1,174.90 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,174.90 | $1,778.28 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,290.87 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $17,378.01 | Facility | None | $1,698.24 | $3,235.94 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,513.56 | $1,778.28 | $2,630.27 |
Pacific Source Setting Facility Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $2,290.87 | Facility | None | $1,348.96 | $2,137.96 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $2,041.74 Median $6,456.54 Typical High $9,549.93 | Facility | None | $2,041.74 | $6,456.54 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,137.96 Typical High $3,019.95 | Professional | None | $79.43 | $2,137.96 | $3,019.95 |
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 $2,137.96 Median $2,238.72 Typical High $2,884.03 | Professional | None | $2,137.96 | $2,238.72 | $2,884.03 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,128.61 Typical High $25,118.86 | Facility | None | $2,691.53 | $5,128.61 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,348.96 | $2,089.30 | $3,467.37 |
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 $645.65 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $645.65 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $1,071.52 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,071.52 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $26,915.35 Median $37,153.52 Typical High $42,657.95 | Facility | 50 · Both sides | $26,915.35 | $37,153.52 | $42,657.95 |
Where Oregon sits
The same service costs 5.0 times more in Colorado than in Kentucky. 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 $14,731KY $2,968
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.