How much rates vary
Facilitymedian $501 · 10th to 90th $347 to $4,169Professionalmedian $457 · 10th to 90th $309 to $708
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 $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $380.19 | Professional | None | $295.12 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,698.24 | Facility | None | $831.76 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $676.08 | Professional | None | $316.23 | $398.11 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $575.44 | Professional | None | $363.08 | $457.09 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $6,025.60 Typical High $8,709.64 | Facility | None | $416.87 | $6,025.60 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $691.83 | Professional | None | $338.84 | $380.19 | $691.83 |
Pacific Source Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $501.19 | Facility | None | $295.12 | $478.63 | $501.19 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,819.70 | Facility | None | $616.60 | $1,230.27 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $467.74 Typical High $724.44 | Professional | None | $79.43 | $467.74 | $724.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $4,073.80 Typical High $4,677.35 | Facility | None | $3,019.95 | $4,073.80 | $4,677.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $660.69 | Professional | None | $467.74 | $501.19 | $660.69 |
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 $371.54 Median $467.74 Typical High $776.25 | Professional | None | $371.54 | $467.74 | $776.25 |
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 $169.82 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $67.61 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $169.82 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $67.61 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $257.04 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $38.02 |
Where Oregon sits
The same service costs 5.6 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 $4,320MT $769
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.