How much rates vary
Facilitymedian $355 · 10th to 90th $240 to $4,786Professionalmedian $331 · 10th to 90th $186 to $490
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 $204.17 Median $275.42 Typical High $275.42 | Professional | None | $204.17 | $275.42 | $275.42 |
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 $245.47 Median $295.12 Typical High $489.78 | Professional | None | $245.47 | $295.12 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $426.58 | Professional | None | $269.15 | $338.84 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $549.54 Typical High $8,709.64 | Facility | None | $302.00 | $549.54 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $467.74 | Professional | None | $263.03 | $281.84 | $467.74 |
Pacific Source Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $363.08 | Facility | None | $213.80 | $346.74 | $363.08 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,548.82 Typical High $2,290.87 | Facility | None | $416.87 | $1,548.82 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $338.84 Typical High $524.81 | Professional | None | $79.43 | $338.84 | $524.81 |
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 $346.74 Median $363.08 Typical High $478.63 | Professional | None | $346.74 | $363.08 | $478.63 |
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 $269.15 Median $338.84 Typical High $549.54 | Professional | None | $269.15 | $338.84 | $549.54 |
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 $107.15 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $42.66 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.38 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $123.03 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $48.98 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $186.21 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $37.15 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $24.55 | $27.54 | $27.54 |
Where Oregon sits
The same service costs 7.3 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 $4,136MT $564
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.