How much rates vary
Facilitymedian $479 · 10th to 90th $324 to $5,129Professionalmedian $372 · 10th to 90th $229 to $617
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 $229.09 Median $302.00 Typical High $302.00 | Professional | None | $229.09 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,698.24 Typical High $2,290.87 | Facility | None | $891.25 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $575.44 | Professional | None | $269.15 | $316.23 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $457.09 | Professional | None | $295.12 | $380.19 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $977.24 Typical High $8,709.64 | Facility | None | $389.05 | $977.24 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $660.69 | Professional | None | $295.12 | $331.13 | $660.69 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $758.58 | Facility | None | $269.15 | $389.05 | $758.58 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $1,513.56 Typical High $2,290.87 | Facility | None | $478.63 | $1,513.56 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $371.54 Typical High $645.65 | Professional | None | $79.43 | $371.54 | $645.65 |
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 $371.54 Median $398.11 Typical High $537.03 | Professional | None | $371.54 | $398.11 | $537.03 |
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 $302.00 Median $389.05 Typical High $676.08 | Professional | None | $302.00 | $389.05 | $676.08 |
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 $123.03 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $48.98 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $24.55 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $134.90 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $53.70 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $204.17 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.92 | $30.20 | $30.20 |
Where Oregon sits
The same service costs 6.8 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 $4,179MT $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.