How much rates vary
Facilitymedian $316 · 10th to 90th $219 to $5,012Professionalmedian $282 · 10th to 90th $182 to $437
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 $165.96 Median $181.97 Typical High $208.93 | Professional | None | $165.96 | $181.97 | $208.93 |
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 $194.98 Median $275.42 Typical High $436.52 | Professional | None | $194.98 | $275.42 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $398.11 | Professional | None | $239.88 | $316.23 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $6,606.93 | Facility | None | $229.09 | $371.54 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $407.38 | Professional | None | $181.97 | $229.09 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $323.59 | Facility | None | $181.97 | $302.00 | $323.59 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $1,513.56 Typical High $2,570.40 | Facility | None | $295.12 | $1,513.56 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $288.40 Typical High $436.52 | Professional | None | $79.43 | $288.40 | $436.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,585.78 Typical High $9,120.11 | Facility | None | $5,248.07 | $7,585.78 | $9,120.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $436.52 | Professional | None | $269.15 | $323.59 | $436.52 |
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 $213.80 Median $309.03 Typical High $489.78 | Professional | None | $213.80 | $309.03 | $489.78 |
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 $91.20 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $138.04 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $30.90 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $20.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $91.20 | $91.20 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $36.31 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 54 · Surgery only | $138.04 | $138.04 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $30.90 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $20.89 |
Where Oregon sits
The same service costs 10.0 times more in Colorado than in North Dakota. 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 $4,594ND $460
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.