How much rates vary
Facilitymedian $617 · 10th to 90th $372 to $5,129Professionalmedian $417 · 10th to 90th $195 to $776
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 $158.49 Median $281.84 Typical High $537.03 | Professional | None | $158.49 | $281.84 | $537.03 |
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 $190.55 Median $416.87 Typical High $891.25 | Professional | None | $190.55 | $416.87 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $812.83 | Professional | None | $309.03 | $436.52 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $660.69 Typical High $7,943.28 | Facility | None | $346.74 | $660.69 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $691.83 | Professional | None | $234.42 | $398.11 | $691.83 |
Pacific Source Setting Facility Modifier None Typical Low $371.54 Median $588.84 Typical High $660.69 | Facility | None | $371.54 | $588.84 | $660.69 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $1,659.59 Typical High $2,754.23 | Facility | None | $407.38 | $1,659.59 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $794.33 | Professional | None | $79.43 | $398.11 | $794.33 |
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 $346.74 Median $512.86 Typical High $660.69 | Professional | None | $346.74 | $512.86 | $660.69 |
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 $288.40 Median $512.86 Typical High $912.01 | Professional | None | $288.40 | $512.86 | $912.01 |
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 $141.25 Median $154.88 Typical High $269.15 | Professional | 52 · Reduced service | $141.25 | $154.88 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $107.15 | Professional | 53 · Discontinued | $56.23 | $61.66 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $407.38 | Professional | 54 · Surgery only | $208.93 | $229.09 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $81.28 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $53.70 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $186.21 Typical High $269.15 | Professional | 52 · Reduced service | $141.25 | $186.21 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $74.13 Typical High $107.15 | Professional | 53 · Discontinued | $56.23 | $74.13 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $281.84 Typical High $407.38 | Professional | 54 · Surgery only | $208.93 | $281.84 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $56.23 Typical High $81.28 | Professional | 55 · Aftercare only | $41.69 | $56.23 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $37.15 Typical High $53.70 | Professional | 56 · Pre-op care only | $28.18 | $37.15 | $53.70 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $263.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $194.98 | $263.03 | $380.19 |
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 6.3 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 $4,654MT $736
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.