How much rates vary
Facilitymedian $1,445 · 10th to 90th $832 to $5,623Professionalmedian $646 · 10th to 90th $240 to $2,042
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 $323.59 Median $5,623.41 Typical High $8,709.64 | Facility | None | $323.59 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $691.83 Typical High $1,202.26 | Professional | None | $181.97 | $691.83 | $1,202.26 |
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 $281.84 Median $794.33 Typical High $2,137.96 | Professional | None | $281.84 | $794.33 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $1,862.09 | Professional | None | $331.13 | $512.86 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $1,621.81 Typical High $7,943.28 | Facility | None | $323.59 | $1,621.81 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $776.25 Typical High $1,584.89 | Professional | None | $199.53 | $776.25 | $1,584.89 |
Pacific Source Setting Facility Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,548.82 | Facility | None | $870.96 | $1,348.96 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $2,630.27 Typical High $4,365.16 | Facility | None | $457.09 | $2,630.27 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $549.54 Typical High $2,137.96 | Professional | None | $79.43 | $549.54 | $2,137.96 |
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 $380.19 Median $676.08 Typical High $2,089.30 | Professional | None | $380.19 | $676.08 | $2,089.30 |
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 $338.84 Median $870.96 Typical High $2,137.96 | Professional | None | $338.84 | $870.96 | $2,137.96 |
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 $131.83 Median $131.83 Typical High $562.34 | Professional | 52 · Reduced service | $131.83 | $131.83 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $223.87 | Professional | 53 · Discontinued | $52.48 | $52.48 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $831.76 | Professional | 54 · Surgery only | $194.98 | $194.98 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $165.96 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $112.20 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $562.34 | Professional | 52 · Reduced service | $131.83 | $131.83 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $223.87 | Professional | 53 · Discontinued | $52.48 | $52.48 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $831.76 | Professional | 54 · Surgery only | $194.98 | $194.98 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $165.96 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $112.20 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $112.20 |
Where Oregon sits
The same service costs 3.8 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 $5,124MT $1,344
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.