How much rates vary
Facilitymedian $398 · 10th to 90th $275 to $4,074Professionalmedian $389 · 10th to 90th $204 to $589
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 $11,748.98 Typical High $24,547.09 | Facility | None | $5,128.61 | $11,748.98 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | None | $281.84 | $281.84 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,659.59 Typical High $2,187.76 | Facility | None | $870.96 | $1,659.59 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $562.34 | Professional | None | $275.42 | $363.08 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $436.52 | Professional | None | $316.23 | $371.54 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $707.95 Typical High $24,547.09 | Facility | None | $407.38 | $707.95 | $24,547.09 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $602.56 | Professional | None | $281.84 | $309.03 | $602.56 |
Pacific Source Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $416.87 | Facility | None | $239.88 | $389.05 | $416.87 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,187.76 | Facility | None | $478.63 | $1,513.56 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $389.05 Typical High $588.84 | Professional | None | $79.43 | $389.05 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,981.07 Median $5,370.32 Typical High $6,456.54 | Facility | None | $3,981.07 | $5,370.32 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $602.56 | Professional | None | $389.05 | $407.38 | $602.56 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $691.83 | Professional | None | $316.23 | $426.58 | $691.83 |
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 $141.25 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Where Oregon sits
The same service costs 7.6 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 $4,681MT $618
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.