How much rates vary
Facilitymedian $214 · 10th to 90th $132 to $661Professionalmedian $151 · 10th to 90th $79 to $288
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 $97.72 Median $199.53 Typical High $5,128.61 | Facility | None | $97.72 | $199.53 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $204.17 | Professional | None | $60.26 | $104.71 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $302.00 | Professional | None | $81.28 | $162.18 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $338.84 | Professional | None | $107.15 | $141.25 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $407.38 Typical High $758.58 | Facility | None | $131.83 | $407.38 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $144.54 Typical High $302.00 | Professional | None | $74.13 | $144.54 | $302.00 |
Pacific Source Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $229.09 | Facility | None | $147.91 | $204.17 | $229.09 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $208.93 Typical High $630.96 | Facility | None | $81.28 | $208.93 | $630.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $288.40 | Professional | None | $79.43 | $154.88 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $794.33 | Facility | None | $524.81 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $229.09 | Professional | None | $112.20 | $199.53 | $229.09 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $309.03 | Professional | None | $93.33 | $169.82 | $309.03 |
10 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 $39.81 Median $39.81 Typical High $81.28 | Professional | 52 · Reduced service | $39.81 | $39.81 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $32.36 | Professional | 53 · Discontinued | $15.85 | $15.85 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $120.23 | Professional | 54 · Surgery only | $58.88 | $58.88 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $23.99 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $16.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $39.81 Typical High $81.28 | Professional | 52 · Reduced service | $39.81 | $39.81 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $32.36 | Professional | 53 · Discontinued | $15.85 | $15.85 | $32.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $58.88 Typical High $120.23 | Professional | 54 · Surgery only | $58.88 | $58.88 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $23.99 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $16.22 |
Where Oregon sits
The same service costs 12.9 times more in Colorado than in Maine. 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 $2,408ME $187
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.