How much rates vary
Facilitymedian $490 · 10th to 90th $269 to $3,236Professionalmedian $234 · 10th to 90th $110 to $646
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 $81.28 Median $213.80 Typical High $457.09 | Professional | None | $81.28 | $213.80 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $537.03 Typical High $870.96 | Facility | None | $426.58 | $537.03 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $269.15 Typical High $707.95 | Professional | None | $109.65 | $269.15 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $758.58 | Professional | None | $134.90 | $208.93 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $512.86 Typical High $6,606.93 | Facility | None | $154.88 | $512.86 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $239.88 Typical High $575.44 | Professional | None | $112.20 | $239.88 | $575.44 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $446.68 Typical High $562.34 | Facility | None | $269.15 | $446.68 | $562.34 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $524.81 Typical High $758.58 | Facility | None | $165.96 | $524.81 | $758.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $707.95 | Professional | None | $79.43 | $218.78 | $707.95 |
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 $144.54 Median $398.11 Typical High $562.34 | Professional | None | $144.54 | $398.11 | $562.34 |
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 $125.89 Median $263.03 Typical High $724.44 | Professional | None | $125.89 | $263.03 | $724.44 |
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 $56.23 Median $109.65 Typical High $229.09 | Professional | 52 · Reduced service | $56.23 | $109.65 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $43.65 Typical High $93.33 | Professional | 53 · Discontinued | $22.39 | $43.65 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $162.18 Typical High $346.74 | Professional | 54 · Surgery only | $85.11 | $162.18 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $32.36 Typical High $69.18 | Professional | 55 · Aftercare only | $16.98 | $32.36 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $23.44 Typical High $45.71 | Professional | 56 · Pre-op care only | $11.22 | $23.44 | $45.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $109.65 Typical High $229.09 | Professional | 52 · Reduced service | $56.23 | $109.65 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $43.65 Typical High $93.33 | Professional | 53 · Discontinued | $22.39 | $43.65 | $93.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $162.18 Typical High $346.74 | Professional | 54 · Surgery only | $85.11 | $162.18 | $346.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $32.36 Typical High $69.18 | Professional | 55 · Aftercare only | $16.98 | $32.36 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $21.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $11.22 | $21.88 | $45.71 |
Where Oregon sits
The same service costs 9.0 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 $4,579MT $507
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.