How much rates vary
Facilitymedian $851 · 10th to 90th $537 to $5,012Professionalmedian $525 · 10th to 90th $282 to $1,000
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 $229.09 Median $416.87 Typical High $602.56 | Professional | None | $229.09 | $416.87 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,454.71 | Facility | None | $691.83 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $524.81 Typical High $1,096.48 | Professional | None | $281.84 | $524.81 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $1,174.90 | Professional | None | $354.81 | $501.19 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $1,023.29 Typical High $7,943.28 | Facility | None | $436.52 | $1,023.29 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $912.01 | Professional | None | $275.42 | $478.63 | $912.01 |
Pacific Source Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $891.25 | Facility | None | $501.19 | $794.33 | $891.25 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,584.89 Typical High $2,454.71 | Facility | None | $537.03 | $1,584.89 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $524.81 Typical High $1,096.48 | Professional | None | $194.98 | $524.81 | $1,096.48 |
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 $363.08 Median $616.60 Typical High $891.25 | Professional | None | $363.08 | $616.60 | $891.25 |
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 $338.84 Median $588.84 Typical High $1,122.02 | Professional | None | $338.84 | $588.84 | $1,122.02 |
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 $151.36 Median $165.96 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $165.96 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $120.23 | Professional | 53 · Discontinued | $61.66 | $66.07 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $446.68 | Professional | 54 · Surgery only | $229.09 | $245.47 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $89.13 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $229.09 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $213.80 | $229.09 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $151.36 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $151.36 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $120.23 | Professional | 53 · Discontinued | $61.66 | $61.66 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $446.68 | Professional | 54 · Surgery only | $229.09 | $229.09 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $89.13 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $60.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $275.42 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $213.80 | $275.42 | $416.87 |
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 4.6 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 $4,728MT $1,029
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.