How much rates vary
Facilitymedian $339 · 10th to 90th $245 to $4,677Professionalmedian $316 · 10th to 90th $170 to $490
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 $204.17 Median $257.04 Typical High $257.04 | Professional | None | $204.17 | $257.04 | $257.04 |
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 $234.42 Median $309.03 Typical High $457.09 | Professional | None | $234.42 | $309.03 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $398.11 | Professional | None | $281.84 | $331.13 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $8,709.64 | Facility | None | $295.12 | $478.63 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $446.68 | Professional | None | $251.19 | $269.15 | $446.68 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $323.59 Typical High $346.74 | Facility | None | $204.17 | $323.59 | $346.74 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $1,445.44 Typical High $2,187.76 | Facility | None | $371.54 | $1,445.44 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $489.78 | Professional | None | $79.43 | $316.23 | $489.78 |
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 $316.23 Median $331.13 Typical High $489.78 | Professional | None | $316.23 | $331.13 | $489.78 |
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 $257.04 Median $371.54 Typical High $575.44 | Professional | None | $257.04 | $371.54 | $575.44 |
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 $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $100.00 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $40.74 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.42 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Where Oregon sits
The same service costs 9.2 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 $4,822MT $526
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.