How much rates vary
Facilitymedian $891 · 10th to 90th $525 to $4,786Professionalmedian $724 · 10th to 90th $437 to $1,259
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 $371.54 Median $512.86 Typical High $794.33 | Professional | None | $371.54 | $512.86 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,344.23 Typical High $3,162.28 | Facility | None | $660.69 | $2,344.23 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $1,318.26 | Professional | None | $489.78 | $794.33 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,148.15 | Professional | None | $588.84 | $812.83 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $6,606.93 | Facility | None | $691.83 | $977.24 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $954.99 | Professional | None | $371.54 | $588.84 | $954.99 |
Pacific Source Setting Facility Modifier None Typical Low $524.81 Median $851.14 Typical High $954.99 | Facility | None | $524.81 | $851.14 | $954.99 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $1,905.46 Typical High $3,162.28 | Facility | None | $645.65 | $1,905.46 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $776.25 Typical High $1,288.25 | Professional | None | $79.43 | $776.25 | $1,288.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $9,772.37 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,258.93 | Professional | None | $630.96 | $912.01 | $1,258.93 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,380.38 | Professional | None | $524.81 | $851.14 | $1,380.38 |
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 $239.88 Median $239.88 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $239.88 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $363.08 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $239.88 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $239.88 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $95.50 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $363.08 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $501.19 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $10,471.29 Median $14,791.08 Typical High $16,982.44 | Facility | 50 · Both sides | $10,471.29 | $14,791.08 | $16,982.44 |
Where Oregon sits
The same service costs 5.0 times more in Colorado than in Delaware. 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 $5,773DE $1,161
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.