How much rates vary
Facilitymedian $282 · 10th to 90th $200 to $5,623Professionalmedian $263 · 10th to 90th $135 to $417
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 $257.04 Median $5,623.41 Typical High $8,709.64 | Facility | None | $257.04 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $208.93 | Professional | None | $141.25 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,162.28 Typical High $4,365.16 | Facility | None | $891.25 | $3,162.28 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $398.11 | Professional | None | $199.53 | $269.15 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $323.59 | Professional | None | $234.42 | $269.15 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $1,318.26 Typical High $7,943.28 | Facility | None | $257.04 | $1,318.26 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $371.54 | Professional | None | $158.49 | $208.93 | $371.54 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $288.40 | Facility | None | $165.96 | $275.42 | $288.40 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $2,884.03 Typical High $4,365.16 | Facility | None | $309.03 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $269.15 Typical High $416.87 | Professional | None | $79.43 | $269.15 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,709.64 Median $12,589.25 Typical High $14,454.40 | Facility | None | $8,709.64 | $12,589.25 | $14,454.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $426.58 | Professional | None | $275.42 | $288.40 | $426.58 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $501.19 | Professional | None | $208.93 | $309.03 | $501.19 |
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 $85.11 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $85.11 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $125.89 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.98 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Where Oregon sits
The same service costs 14.3 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 $6,102MT $428
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.