How much rates vary
Facilitymedian $513 · 10th to 90th $302 to $5,370Professionalmedian $355 · 10th to 90th $155 to $692
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 $302.00 Median $3,890.45 Typical High $8,709.64 | Facility | None | $302.00 | $3,890.45 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $478.63 | Professional | None | $141.25 | $288.40 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,137.96 | Facility | None | $891.25 | $1,621.81 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $354.81 Typical High $707.95 | Professional | None | $190.55 | $354.81 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $707.95 | Professional | None | $229.09 | $354.81 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $1,348.96 Typical High $6,165.95 | Facility | None | $302.00 | $1,348.96 | $6,165.95 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $302.00 Typical High $588.84 | Professional | None | $141.25 | $302.00 | $588.84 |
Pacific Source Setting Facility Modifier None Typical Low $288.40 Median $478.63 Typical High $549.54 | Facility | None | $288.40 | $478.63 | $549.54 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $1,380.38 Typical High $2,137.96 | Facility | None | $323.59 | $1,380.38 | $2,137.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $707.95 | Professional | None | $79.43 | $354.81 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,265.80 Median $5,888.44 Typical High $6,918.31 | Facility | None | $4,265.80 | $5,888.44 | $6,918.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $691.83 | Professional | None | $251.19 | $426.58 | $691.83 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $223.87 Median $407.38 Typical High $724.44 | Professional | None | $223.87 | $407.38 | $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 $100.00 Median $100.00 Typical High $199.53 | Professional | 52 · Reduced service | $100.00 | $100.00 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $79.43 | Professional | 53 · Discontinued | $39.81 | $39.81 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $302.00 | Professional | 54 · Surgery only | $147.91 | $147.91 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $199.53 | Professional | 52 · Reduced service | $100.00 | $100.00 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $79.43 | Professional | 53 · Discontinued | $39.81 | $39.81 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $302.00 | Professional | 54 · Surgery only | $147.91 | $147.91 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $39.81 |
Where Oregon sits
The same service costs 8.2 times more in Colorado than in West Virginia. 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 $4,192WV $514
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.