How much rates vary
Facilitymedian $427 · 10th to 90th $245 to $4,266Professionalmedian $234 · 10th to 90th $107 to $575
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 $190.55 Median $4,265.80 Typical High $7,943.28 | Facility | None | $190.55 | $4,265.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $389.05 | Professional | None | $107.15 | $218.78 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,019.95 Typical High $4,168.69 | Facility | None | $660.69 | $3,019.95 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $251.19 Typical High $588.84 | Professional | None | $131.83 | $251.19 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $588.84 | Professional | None | $151.36 | $223.87 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $645.65 Typical High $7,943.28 | Facility | None | $158.49 | $645.65 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $213.80 Typical High $457.09 | Professional | None | $91.20 | $213.80 | $457.09 |
Pacific Source Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $446.68 | Facility | None | $245.47 | $407.38 | $446.68 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $2,454.71 Typical High $4,168.69 | Facility | None | $288.40 | $2,454.71 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $588.84 | Professional | None | $79.43 | $245.47 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,311.31 Median $8,511.38 Typical High $12,882.50 | Facility | None | $3,311.31 | $8,511.38 | $12,882.50 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $630.96 | Professional | None | $158.49 | $288.40 | $630.96 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $630.96 | Professional | None | $154.88 | $309.03 | $630.96 |
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 $56.23 Median $89.13 Typical High $154.88 | Professional | 52 · Reduced service | $56.23 | $89.13 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $35.48 Typical High $63.10 | Professional | 53 · Discontinued | $22.39 | $35.48 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $234.42 | Professional | 54 · Surgery only | $83.18 | $134.90 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $26.92 Typical High $46.77 | Professional | 55 · Aftercare only | $16.98 | $26.92 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.78 Typical High $31.62 | Professional | 56 · Pre-op care only | $11.22 | $17.78 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $56.23 | $154.88 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.91 Typical High $63.10 | Professional | 53 · Discontinued | $22.39 | $22.91 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $85.11 Typical High $234.42 | Professional | 54 · Surgery only | $83.18 | $85.11 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $46.77 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $31.62 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $31.62 |
Where Oregon sits
The same service costs 10.4 times more in Colorado than in North Dakota. 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 $4,594ND $443
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.