How much rates vary
Facilitymedian $468 · 10th to 90th $288 to $4,074Professionalmedian $437 · 10th to 90th $229 to $631
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 $223.87 Median $323.59 Typical High $323.59 | Professional | None | $223.87 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,659.59 Typical High $2,238.72 | Facility | None | $870.96 | $1,659.59 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $630.96 | Professional | None | $239.88 | $380.19 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $549.54 | Professional | None | $389.05 | $457.09 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $8,709.64 | Facility | None | $354.81 | $660.69 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $537.03 | Professional | None | $245.47 | $354.81 | $537.03 |
Pacific Source Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $478.63 | Facility | None | $281.84 | $457.09 | $478.63 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $1,479.11 Typical High $2,137.96 | Facility | None | $426.58 | $1,479.11 | $2,137.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $645.65 | Professional | None | $79.43 | $446.68 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,309.57 | Facility | None | $4,073.80 | $5,623.41 | $6,309.57 |
Regence BlueShield Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $630.96 | Professional | None | $457.09 | $478.63 | $630.96 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $724.44 | Professional | None | $309.03 | $436.52 | $724.44 |
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 $138.04 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $138.04 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $54.95 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $27.54 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $245.47 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
Where Oregon sits
The same service costs 6.2 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 $4,689MT $752
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.