How much rates vary
Facilitymedian $269 · 10th to 90th $209 to $5,754Professionalmedian $245 · 10th to 90th $145 to $398
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 $169.82 Median $208.93 Typical High $223.87 | Professional | None | $169.82 | $208.93 | $223.87 |
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 $162.18 Median $223.87 Typical High $380.19 | Professional | None | $162.18 | $223.87 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $295.12 | Professional | None | $208.93 | $251.19 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $575.44 Typical High $8,709.64 | Facility | None | $295.12 | $575.44 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $426.58 | Professional | None | $181.97 | $208.93 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $316.23 | Facility | None | $169.82 | $257.04 | $316.23 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $1,905.46 Typical High $2,754.23 | Facility | None | $331.13 | $1,905.46 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $251.19 Typical High $398.11 | Professional | None | $79.43 | $251.19 | $398.11 |
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 $257.04 Median $269.15 Typical High $346.74 | Professional | None | $257.04 | $269.15 | $346.74 |
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 $204.17 Median $269.15 Typical High $457.09 | Professional | None | $204.17 | $269.15 | $457.09 |
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 $102.33 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $40.74 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.20 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $141.25 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $102.33 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $40.74 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $151.36 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $30.20 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $141.25 | $144.54 | $144.54 |
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 11.0 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 $4,556MT $413
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.