How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,585 to $10,233Professionalmedian $2,291 · 10th to 90th $1,259 to $3,548
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 $10,232.93 Typical High $24,547.09 | Facility | None | $5,128.61 | $10,232.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,698.24 | $1,905.46 |
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 $1,318.26 Median $2,089.30 Typical High $3,548.13 | Professional | None | $1,318.26 | $2,089.30 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,235.94 | Professional | None | $2,238.72 | $2,630.27 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $2,344.23 Median $7,943.28 Typical High $21,877.62 | Facility | None | $2,344.23 | $7,943.28 | $21,877.62 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,995.26 | $2,951.21 |
Pacific Source Setting Facility Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,454.71 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $2,187.76 Median $6,456.54 Typical High $9,549.93 | Facility | None | $2,187.76 | $6,456.54 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,398.83 Typical High $3,548.13 | Professional | None | $79.43 | $2,398.83 | $3,548.13 |
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 $2,511.89 Median $2,630.27 Typical High $3,388.44 | Professional | None | $2,511.89 | $2,630.27 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,495.41 Typical High $25,118.86 | Facility | None | $2,691.53 | $5,495.41 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,548.82 | $2,344.23 | $3,801.89 |
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 $758.58 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,122.02 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,202.26 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,202.26 | $1,202.26 |
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 4.7 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 $15,002KY $3,224
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.