How much rates vary
Facilitymedian $575 · 10th to 90th $407 to $9,550Professionalmedian $513 · 10th to 90th $282 to $759
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 $5,128.61 Median $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | None | $338.84 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,309.57 Typical High $8,709.64 | Facility | None | $1,000.00 | $6,309.57 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $741.31 | Professional | None | $363.08 | $436.52 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $630.96 | Professional | None | $416.87 | $524.81 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $6,918.31 Typical High $17,378.01 | Facility | None | $588.84 | $6,918.31 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $691.83 | Professional | None | $407.38 | $446.68 | $691.83 |
Pacific Source Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $602.56 | Facility | None | $363.08 | $537.03 | $602.56 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $5,623.41 Typical High $8,709.64 | Facility | None | $660.69 | $5,623.41 | $8,709.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $794.33 | Professional | None | $79.43 | $524.81 | $794.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $13,803.84 Typical High $26,302.68 | Facility | None | $9,332.54 | $13,803.84 | $26,302.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $724.44 | Professional | None | $524.81 | $549.54 | $724.44 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,897.79 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,897.79 | $25,118.86 |
United Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $851.14 | Professional | None | $416.87 | $524.81 | $851.14 |
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 $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $72.44 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $269.15 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $53.70 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $40.74 |
Where Oregon sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.