How much rates vary
Facilitymedian $741 · 10th to 90th $447 to $7,413Professionalmedian $676 · 10th to 90th $380 to $1,023
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 $691.83 Median $8,317.64 Typical High $17,378.01 | Facility | None | $691.83 | $8,317.64 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $562.34 | Professional | None | $363.08 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,778.28 Typical High $2,454.71 | Facility | None | $1,023.29 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $1,000.00 | Professional | None | $457.09 | $602.56 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $870.96 | Professional | None | $549.54 | $691.83 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $2,754.23 Typical High $13,182.57 | Facility | None | $53.70 | $2,754.23 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $1,071.52 | Professional | None | $371.54 | $562.34 | $1,071.52 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $724.44 Typical High $741.31 | Facility | None | $436.52 | $724.44 | $741.31 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $2,754.23 | Facility | None | $758.58 | $1,737.80 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $707.95 Typical High $1,071.52 | Professional | None | $79.43 | $707.95 | $1,071.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,165.95 Median $9,332.54 Typical High $13,489.63 | Facility | None | $6,165.95 | $9,332.54 | $13,489.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,000.00 | Professional | None | $707.95 | $741.31 | $1,000.00 |
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 $562.34 Median $691.83 Typical High $1,148.15 | Professional | None | $562.34 | $691.83 | $1,148.15 |
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 $218.78 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $89.13 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $331.13 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $257.04 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $102.33 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $380.19 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $56.23 |
Where Oregon sits
The same service costs 5.0 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 $5,749MT $1,151
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.