How much rates vary
Facilitymedian $708 · 10th to 90th $257 to $4,677Professionalmedian $380 · 10th to 90th $186 to $912
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $616.60 | Professional | None | $154.88 | $194.98 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $2,290.87 | Facility | None | $660.69 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $398.11 Typical High $977.24 | Professional | None | $186.21 | $398.11 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $1,023.29 | Professional | None | $218.78 | $338.84 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $676.08 Typical High $7,943.28 | Facility | None | $257.04 | $676.08 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $794.33 | Professional | None | $194.98 | $316.23 | $794.33 |
Pacific Source Setting Facility Modifier None Typical Low $239.88 Median $630.96 Typical High $776.25 | Facility | None | $239.88 | $630.96 | $776.25 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,445.44 Typical High $2,290.87 | Facility | None | $302.00 | $1,445.44 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $346.74 Typical High $977.24 | Professional | None | $79.43 | $346.74 | $977.24 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,677.35 Median $6,606.93 Typical High $7,585.78 | Facility | None | $4,677.35 | $6,606.93 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $776.25 | Professional | None | $245.47 | $562.34 | $776.25 |
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 $213.80 Median $416.87 Typical High $1,000.00 | Professional | None | $213.80 | $416.87 | $1,000.00 |
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 $97.72 Median $173.78 Typical High $309.03 | Professional | 52 · Reduced service | $97.72 | $173.78 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $69.18 Typical High $123.03 | Professional | 53 · Discontinued | $38.90 | $69.18 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $257.04 Typical High $467.74 | Professional | 54 · Surgery only | $144.54 | $257.04 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $51.29 Typical High $93.33 | Professional | 55 · Aftercare only | $29.51 | $51.29 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $34.67 Typical High $61.66 | Professional | 56 · Pre-op care only | $19.50 | $34.67 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $173.78 Typical High $309.03 | Professional | 52 · Reduced service | $97.72 | $173.78 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $69.18 Typical High $123.03 | Professional | 53 · Discontinued | $38.90 | $69.18 | $123.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $263.03 Typical High $467.74 | Professional | 54 · Surgery only | $144.54 | $263.03 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $52.48 Typical High $93.33 | Professional | 55 · Aftercare only | $29.51 | $52.48 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $34.67 Typical High $61.66 | Professional | 56 · Pre-op care only | $19.50 | $34.67 | $61.66 |
Where Oregon sits
The same service costs 5.7 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 $4,090MT $722
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.