How much rates vary
Facilitymedian $372 · 10th to 90th $263 to $6,026Professionalmedian $339 · 10th to 90th $174 to $550
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 $338.84 Median $5,623.41 Typical High $8,709.64 | Facility | None | $338.84 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $275.42 | Professional | None | $173.78 | $251.19 | $275.42 |
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 $263.03 Median $338.84 Typical High $512.86 | Professional | None | $263.03 | $338.84 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $416.87 | Professional | None | $302.00 | $346.74 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $8,709.64 | Facility | None | $331.13 | $537.03 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $467.74 | Professional | None | $186.21 | $275.42 | $467.74 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $363.08 Typical High $380.19 | Facility | None | $218.78 | $363.08 | $380.19 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $2,884.03 Typical High $4,365.16 | Facility | None | $407.38 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $549.54 | Professional | None | $79.43 | $354.81 | $549.54 |
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 $363.08 Median $380.19 Typical High $562.34 | Professional | None | $363.08 | $380.19 | $562.34 |
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 $275.42 Median $398.11 Typical High $660.69 | Professional | None | $275.42 | $398.11 | $660.69 |
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 $112.20 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $112.20 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $44.67 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $165.96 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.39 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $54.95 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
Where Oregon sits
The same service costs 11.3 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 $6,301MT $557
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.