How much rates vary
Facilitymedian $339 · 10th to 90th $245 to $3,311Professionalmedian $316 · 10th to 90th $200 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 $3,235.94 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 $229.09 Median $257.04 Typical High $257.04 | Professional | None | $229.09 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $1,698.24 | Facility | None | $660.69 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $457.09 | Professional | None | $223.87 | $275.42 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $398.11 | Professional | None | $257.04 | $323.59 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $3,235.94 Typical High $7,943.28 | Facility | None | $354.81 | $3,235.94 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $489.78 | Professional | None | $251.19 | $263.03 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $416.87 | Facility | None | $213.80 | $323.59 | $416.87 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,148.15 Typical High $1,698.24 | Facility | None | $416.87 | $1,148.15 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $489.78 | Professional | None | $79.43 | $323.59 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $4,677.35 | Facility | None | $3,019.95 | $4,168.69 | $4,677.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $457.09 | Professional | None | $323.59 | $338.84 | $457.09 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $549.54 | Professional | None | $257.04 | $323.59 | $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 $112.20 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $114.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $173.78 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $25.70 |
Where Oregon sits
The same service costs 7.7 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 $4,047MT $526
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.