How much rates vary
Facilitymedian $186 · 10th to 90th $145 to $5,012Professionalmedian $182 · 10th to 90th $100 to $282
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 $102.33 Median $125.89 Typical High $134.90 | Professional | None | $102.33 | $125.89 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,862.09 Typical High $2,570.40 | Facility | None | $660.69 | $1,862.09 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $263.03 | Professional | None | $134.90 | $169.82 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $223.87 | Professional | None | $162.18 | $186.21 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $302.00 Typical High $7,943.28 | Facility | None | $158.49 | $302.00 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $302.00 | Professional | None | $107.15 | $141.25 | $302.00 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $186.21 Typical High $190.55 | Facility | None | $112.20 | $186.21 | $190.55 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $1,698.24 Typical High $2,570.40 | Facility | None | $213.80 | $1,698.24 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $281.84 | Professional | None | $79.43 | $177.83 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $8,128.31 | Facility | None | $5,248.07 | $7,244.36 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $288.40 | Professional | None | $181.97 | $190.55 | $288.40 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $331.13 | Professional | None | $141.25 | $204.17 | $331.13 |
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 $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 54 · Surgery only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 54 · Surgery only | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Where Oregon sits
The same service costs 15.6 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 $4,608MT $296
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.