How much rates vary
Facilitymedian $1,380 · 10th to 90th $794 to $5,248Professionalmedian $562 · 10th to 90th $229 to $1,950
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 $281.84 Median $5,623.41 Typical High $8,709.64 | Facility | None | $281.84 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $660.69 Typical High $1,071.52 | Professional | None | $213.80 | $660.69 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,235.94 Typical High $4,365.16 | Facility | None | $891.25 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $758.58 Typical High $2,041.74 | Professional | None | $245.47 | $758.58 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $1,819.70 | Professional | None | $288.40 | $436.52 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $1,318.26 Typical High $7,943.28 | Facility | None | $281.84 | $1,318.26 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $660.69 Typical High $1,513.56 | Professional | None | $229.09 | $660.69 | $1,513.56 |
Pacific Source Setting Facility Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,479.11 | Facility | None | $812.83 | $1,258.93 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $2,630.27 Typical High $4,365.16 | Facility | None | $426.58 | $2,630.27 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $467.74 Typical High $2,041.74 | Professional | None | $79.43 | $467.74 | $2,041.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $9,332.54 Typical High $13,803.84 | Facility | None | $5,248.07 | $9,332.54 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $1,995.26 | Professional | None | $331.13 | $588.84 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $295.12 Median $758.58 Typical High $2,041.74 | Professional | None | $295.12 | $758.58 | $2,041.74 |
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 $147.91 Typical High $537.03 | Professional | 52 · Reduced service | $112.20 | $147.91 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $213.80 | Professional | 53 · Discontinued | $45.71 | $58.88 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $223.87 Typical High $812.83 | Professional | 54 · Surgery only | $169.82 | $223.87 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $44.67 Typical High $162.18 | Professional | 55 · Aftercare only | $33.88 | $44.67 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $29.51 Typical High $107.15 | Professional | 56 · Pre-op care only | $22.91 | $29.51 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $537.03 | Professional | 52 · Reduced service | $112.20 | $112.20 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $213.80 | Professional | 53 · Discontinued | $45.71 | $45.71 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $812.83 | Professional | 54 · Surgery only | $169.82 | $169.82 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $162.18 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $107.15 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $107.15 |
Where Oregon sits
The same service costs 4.0 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 $5,041MT $1,267
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.