How much rates vary
Facilitymedian $316 · 10th to 90th $224 to $6,026Professionalmedian $302 · 10th to 90th $148 to $468
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 $147.91 Median $234.42 Typical High $234.42 | Professional | None | $147.91 | $234.42 | $234.42 |
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 $223.87 Median $295.12 Typical High $436.52 | Professional | None | $223.87 | $295.12 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $354.81 | Professional | None | $257.04 | $295.12 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $457.09 Typical High $8,709.64 | Facility | None | $275.42 | $457.09 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $436.52 | Professional | None | $229.09 | $239.88 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $186.21 Median $309.03 Typical High $323.59 | Facility | None | $186.21 | $309.03 | $323.59 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $2,884.03 Typical High $4,365.16 | Facility | None | $346.74 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $302.00 Typical High $467.74 | Professional | None | $79.43 | $302.00 | $467.74 |
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 $309.03 Median $323.59 Typical High $478.63 | Professional | None | $309.03 | $323.59 | $478.63 |
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 $234.42 Median $346.74 Typical High $562.34 | Professional | None | $234.42 | $346.74 | $562.34 |
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 $95.50 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $95.50 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $38.02 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $141.25 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $117.49 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
Where Oregon sits
The same service costs 13.0 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 $6,260MT $480
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.