How much rates vary
Facilitymedian $1,479 · 10th to 90th $871 to $5,012Professionalmedian $1,096 · 10th to 90th $631 to $1,820
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 $630.96 Median $724.44 Typical High $1,096.48 | Professional | None | $630.96 | $724.44 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,778.28 Typical High $2,454.71 | Facility | None | $660.69 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,905.46 | Professional | None | $676.08 | $1,122.02 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $2,137.96 | Professional | None | $870.96 | $1,258.93 | $2,137.96 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $7,244.36 | Facility | None | $691.83 | $1,513.56 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $1,621.81 | Professional | None | $630.96 | $1,096.48 | $1,621.81 |
Pacific Source Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,548.82 | Facility | None | $891.25 | $1,412.54 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $2,454.71 | Facility | None | $660.69 | $1,659.59 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,905.46 | Professional | None | $79.43 | $1,122.02 | $1,905.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $6,918.31 Typical High $7,762.47 | Facility | None | $5,128.61 | $6,918.31 | $7,762.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,548.82 | Professional | None | $933.25 | $1,445.44 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,174.90 Typical High $2,041.74 | Professional | None | $724.44 | $1,174.90 | $2,041.74 |
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 $316.23 Median $316.23 Typical High $549.54 | Professional | 52 · Reduced service | $316.23 | $316.23 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $218.78 | Professional | 53 · Discontinued | $125.89 | $125.89 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $812.83 | Professional | 54 · Surgery only | $467.74 | $478.63 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $162.18 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $109.65 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $316.23 Typical High $549.54 | Professional | 52 · Reduced service | $316.23 | $316.23 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $218.78 | Professional | 53 · Discontinued | $125.89 | $125.89 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $812.83 | Professional | 54 · Surgery only | $467.74 | $467.74 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $162.18 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $109.65 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $758.58 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $7,762.47 Median $10,232.93 Typical High $11,481.54 | Facility | 50 · Both sides | $7,762.47 | $10,232.93 | $11,481.54 |
Where Oregon sits
The same service costs 3.0 times more in Colorado than in Maryland. 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 $5,106MD $1,697
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.