How much rates vary
Facilitymedian $851 · 10th to 90th $355 to $5,129Professionalmedian $457 · 10th to 90th $240 to $1,072
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 $194.98 Median $257.04 Typical High $741.31 | Professional | None | $194.98 | $257.04 | $741.31 |
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 $239.88 Median $478.63 Typical High $1,122.02 | Professional | None | $239.88 | $478.63 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $1,230.27 | Professional | None | $288.40 | $446.68 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $954.99 Typical High $7,943.28 | Facility | None | $363.08 | $954.99 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $933.25 | Professional | None | $251.19 | $371.54 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $331.13 Median $776.25 Typical High $891.25 | Facility | None | $331.13 | $776.25 | $891.25 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $1,445.44 Typical High $2,290.87 | Facility | None | $398.11 | $1,445.44 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $1,148.15 | Professional | None | $79.43 | $446.68 | $1,148.15 |
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 $323.59 Median $645.65 Typical High $912.01 | Professional | None | $323.59 | $645.65 | $912.01 |
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 $281.84 Median $549.54 Typical High $1,174.90 | Professional | None | $281.84 | $549.54 | $1,174.90 |
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 $128.82 Median $199.53 Typical High $371.54 | Professional | 52 · Reduced service | $128.82 | $199.53 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $81.28 Typical High $147.91 | Professional | 53 · Discontinued | $51.29 | $81.28 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $302.00 Typical High $562.34 | Professional | 54 · Surgery only | $190.55 | $302.00 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $60.26 Typical High $112.20 | Professional | 55 · Aftercare only | $38.02 | $60.26 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $39.81 Typical High $74.13 | Professional | 56 · Pre-op care only | $25.70 | $39.81 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $204.17 Typical High $371.54 | Professional | 52 · Reduced service | $128.82 | $204.17 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $81.28 Typical High $147.91 | Professional | 53 · Discontinued | $51.29 | $81.28 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $302.00 Typical High $562.34 | Professional | 54 · Surgery only | $190.55 | $302.00 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $60.26 Typical High $112.20 | Professional | 55 · Aftercare only | $38.02 | $60.26 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $40.74 Typical High $74.13 | Professional | 56 · Pre-op care only | $25.70 | $40.74 | $74.13 |
Where Oregon sits
The same service costs 5.4 times more in Colorado than in West Virginia. 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 $4,173WV $767
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.