How much rates vary
Facilitymedian $1,122 · 10th to 90th $741 to $6,166Professionalmedian $912 · 10th to 90th $447 to $1,514
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $912.01 | Professional | None | $501.19 | $724.44 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $2,754.23 | Facility | None | $1,000.00 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $851.14 Typical High $1,584.89 | Professional | None | $446.68 | $851.14 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,412.54 | Professional | None | $758.58 | $1,071.52 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $1,288.25 Typical High $13,182.57 | Facility | None | $794.33 | $1,288.25 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,479.11 | Professional | None | $645.65 | $912.01 | $1,479.11 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,148.15 | Facility | None | $645.65 | $1,071.52 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $2,754.23 | Facility | None | $831.76 | $1,778.28 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $891.25 Typical High $1,513.56 | Professional | None | $79.43 | $891.25 | $1,513.56 |
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 $891.25 Median $1,096.48 Typical High $1,288.25 | Professional | None | $891.25 | $1,096.48 | $1,288.25 |
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 $707.95 Median $977.24 Typical High $1,621.81 | Professional | None | $707.95 | $977.24 | $1,621.81 |
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 $354.81 Median $363.08 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $363.08 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $363.08 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $144.54 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $549.54 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $630.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,709.64 Median $12,302.69 Typical High $13,803.84 | Facility | 50 · Both sides | $8,709.64 | $12,302.69 | $13,803.84 |
Where Oregon sits
The same service costs 3.2 times more in Colorado than in North Dakota. 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 $5,011ND $1,553
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.