How much rates vary
Facilitymedian $295 · 10th to 90th $200 to $5,012Professionalmedian $224 · 10th to 90th $126 to $398
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 $218.78 Median $3,235.94 Typical High $7,943.28 | Facility | None | $218.78 | $3,235.94 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $263.03 | Professional | None | $100.00 | $165.96 | $263.03 |
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 $223.87 Typical High $407.38 | Professional | None | $134.90 | $223.87 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $363.08 | Professional | None | $158.49 | $245.47 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $354.81 Typical High $6,606.93 | Facility | None | $165.96 | $354.81 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $426.58 | Professional | None | $125.89 | $218.78 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $186.21 Median $288.40 Typical High $302.00 | Facility | None | $186.21 | $288.40 | $302.00 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $1,513.56 Typical High $2,570.40 | Facility | None | $223.87 | $1,513.56 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $407.38 | Professional | None | $79.43 | $234.42 | $407.38 |
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 $281.84 Typical High $398.11 | Professional | None | $181.97 | $281.84 | $398.11 |
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 $165.96 Median $263.03 Typical High $426.58 | Professional | None | $165.96 | $263.03 | $426.58 |
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 $67.61 Median $67.61 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $67.61 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $44.67 | Professional | 53 · Discontinued | $27.54 | $27.54 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $165.96 | Professional | 54 · Surgery only | $102.33 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $33.11 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $21.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $67.61 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $33.11 Typical High $44.67 | Professional | 53 · Discontinued | $27.54 | $33.11 | $44.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $165.96 | Professional | 54 · Surgery only | $102.33 | $102.33 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $33.11 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $21.88 |
Where Oregon sits
The same service costs 12.7 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 $4,551ND $359
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.