How much rates vary
Facilitymedian $794 · 10th to 90th $479 to $4,898Professionalmedian $389 · 10th to 90th $178 to $977
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 $251.19 Median $3,890.45 Typical High $7,943.28 | Facility | None | $251.19 | $3,890.45 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $338.84 Typical High $676.08 | Professional | None | $120.23 | $338.84 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,905.46 | Facility | None | $812.83 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $977.24 | Professional | None | $186.21 | $389.05 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $933.25 | Professional | None | $229.09 | $331.13 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $870.96 Typical High $7,943.28 | Facility | None | $229.09 | $870.96 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $407.38 Typical High $912.01 | Professional | None | $181.97 | $407.38 | $912.01 |
Pacific Source Setting Facility Modifier None Typical Low $478.63 Median $741.31 Typical High $1,000.00 | Facility | None | $478.63 | $741.31 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $1,288.25 Typical High $1,905.46 | Facility | None | $263.03 | $1,288.25 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $346.74 Typical High $1,047.13 | Professional | None | $79.43 | $346.74 | $1,047.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $758.58 | Professional | None | $245.47 | $436.52 | $758.58 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $194.98 Median $478.63 Typical High $1,000.00 | Professional | None | $194.98 | $478.63 | $1,000.00 |
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 $91.20 Median $91.20 Typical High $302.00 | Professional | 52 · Reduced service | $91.20 | $91.20 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $120.23 | Professional | 53 · Discontinued | $36.31 | $36.31 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $457.09 | Professional | 54 · Surgery only | $134.90 | $134.90 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $91.20 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $60.26 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $302.00 | Professional | 52 · Reduced service | $91.20 | $91.20 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $120.23 | Professional | 53 · Discontinued | $36.31 | $36.31 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $457.09 | Professional | 54 · Surgery only | $134.90 | $134.90 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $91.20 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $18.20 | $33.88 | $60.26 |
Where Oregon sits
The same service costs 5.1 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 $4,353ND $853
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.