How much rates vary
Facilitymedian $479 · 10th to 90th $347 to $5,623Professionalmedian $457 · 10th to 90th $229 to $708
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 $446.68 Median $5,623.41 Typical High $8,709.64 | Facility | None | $446.68 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $363.08 | Professional | None | $229.09 | $363.08 | $363.08 |
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 $338.84 Median $436.52 Typical High $676.08 | Professional | None | $338.84 | $436.52 | $676.08 |
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 $446.68 Median $1,122.02 Typical High $8,709.64 | Facility | None | $446.68 | $1,122.02 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $645.65 | Professional | None | $239.88 | $363.08 | $645.65 |
Pacific Source Setting Facility Modifier None Typical Low $288.40 Median $478.63 Typical High $501.19 | Facility | None | $288.40 | $478.63 | $501.19 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,884.03 Typical High $4,365.16 | Facility | None | $537.03 | $2,884.03 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $467.74 Typical High $724.44 | Professional | None | $79.43 | $467.74 | $724.44 |
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 $467.74 Median $501.19 Typical High $741.31 | Professional | None | $467.74 | $501.19 | $741.31 |
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 $363.08 Median $524.81 Typical High $851.14 | Professional | None | $363.08 | $524.81 | $851.14 |
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 $147.91 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $147.91 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $58.88 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $218.78 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $43.65 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $29.51 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $72.44 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Where Oregon sits
The same service costs 8.5 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 $6,252MT $735
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.