How much rates vary
Facilitymedian $724 · 10th to 90th $437 to $5,623Professionalmedian $631 · 10th to 90th $288 to $1,023
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $562.34 | Professional | None | $302.00 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,089.30 Typical High $2,754.23 | Facility | None | $891.25 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $616.60 Typical High $1,047.13 | Professional | None | $288.40 | $616.60 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $676.08 Typical High $812.83 | Professional | None | $316.23 | $676.08 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,047.13 Typical High $8,709.64 | Facility | None | $575.44 | $1,047.13 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $977.24 | Professional | None | $354.81 | $562.34 | $977.24 |
Pacific Source Setting Facility Modifier None Typical Low $416.87 Median $691.83 Typical High $741.31 | Facility | None | $416.87 | $691.83 | $741.31 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $2,754.23 | Facility | None | $630.96 | $1,862.09 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $630.96 Typical High $1,023.29 | Professional | None | $79.43 | $630.96 | $1,023.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $9,332.54 | Facility | None | $5,754.40 | $8,128.31 | $9,332.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $912.01 | Professional | None | $691.83 | $741.31 | $912.01 |
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 $489.78 Median $676.08 Typical High $1,174.90 | Professional | None | $489.78 | $676.08 | $1,174.90 |
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 $234.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $323.59 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $275.42 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $416.87 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $389.05 | $398.11 | $398.11 |
Where Oregon sits
The same service costs 4.5 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 $4,914MT $1,099
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.