How much rates vary
Facilitymedian $1,585 · 10th to 90th $912 to $5,495Professionalmedian $617 · 10th to 90th $269 to $2,089
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 $436.52 Median $5,128.61 Typical High $8,709.64 | Facility | None | $436.52 | $5,128.61 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $831.76 Typical High $1,479.11 | Professional | None | $251.19 | $831.76 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,238.72 | Facility | None | $1,023.29 | $1,479.11 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $630.96 Typical High $2,238.72 | Professional | None | $269.15 | $630.96 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $2,089.30 | Professional | None | $316.23 | $478.63 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $2,137.96 Typical High $7,943.28 | Facility | None | $416.87 | $2,137.96 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $776.25 Typical High $1,778.28 | Professional | None | $281.84 | $776.25 | $1,778.28 |
Pacific Source Setting Facility Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $1,737.80 | Facility | None | $1,000.00 | $1,584.89 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $1,479.11 Typical High $2,398.83 | Facility | None | $478.63 | $1,479.11 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $549.54 Typical High $2,290.87 | Professional | None | $194.98 | $549.54 | $2,290.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $1,348.96 Typical High $1,737.80 | Professional | None | $363.08 | $1,348.96 | $1,737.80 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $331.13 Median $851.14 Typical High $2,290.87 | Professional | None | $331.13 | $851.14 | $2,290.87 |
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 $147.91 Median $389.05 Typical High $741.31 | Professional | 52 · Reduced service | $147.91 | $389.05 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $154.88 Typical High $295.12 | Professional | 53 · Discontinued | $58.88 | $154.88 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $588.84 Typical High $1,122.02 | Professional | 54 · Surgery only | $218.78 | $588.84 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $117.49 Typical High $223.87 | Professional | 55 · Aftercare only | $43.65 | $117.49 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $77.62 Typical High $147.91 | Professional | 56 · Pre-op care only | $29.51 | $77.62 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $389.05 Typical High $741.31 | Professional | 52 · Reduced service | $147.91 | $389.05 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $154.88 Typical High $295.12 | Professional | 53 · Discontinued | $58.88 | $154.88 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $588.84 Typical High $1,122.02 | Professional | 54 · Surgery only | $218.78 | $588.84 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $117.49 Typical High $223.87 | Professional | 55 · Aftercare only | $43.65 | $117.49 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $77.62 Typical High $147.91 | Professional | 56 · Pre-op care only | $29.51 | $77.62 | $147.91 |
Where Oregon sits
The same service costs 5.2 times more in Colorado than in Maryland. 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 $5,090MD $977
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.