How much rates vary
Facilitymedian $501 · 10th to 90th $355 to $9,550Professionalmedian $479 · 10th to 90th $269 to $741
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 $5,128.61 Median $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $371.54 | Professional | None | $269.15 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $5,754.40 Typical High $7,762.47 | Facility | None | $2,187.76 | $5,754.40 | $7,762.47 |
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 $436.52 Median $501.19 Typical High $602.56 | Professional | None | $436.52 | $501.19 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $6,918.31 Typical High $17,378.01 | Facility | None | $407.38 | $6,918.31 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $660.69 | Professional | None | $309.03 | $371.54 | $660.69 |
Pacific Source Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $512.86 | Facility | None | $302.00 | $478.63 | $512.86 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $5,495.41 Typical High $8,317.64 | Facility | None | $616.60 | $5,495.41 | $8,317.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $478.63 Typical High $741.31 | Professional | None | $79.43 | $478.63 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,454.40 Median $19,952.62 Typical High $22,908.68 | Facility | None | $14,454.40 | $19,952.62 | $22,908.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $758.58 | Professional | None | $478.63 | $501.19 | $758.58 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $870.96 | Professional | None | $389.05 | $549.54 | $870.96 |
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 $154.88 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $61.66 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $46.77 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.90 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
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 $10,613MT $815
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.