How much rates vary
Facilitymedian $513 · 10th to 90th $372 to $4,571Professionalmedian $490 · 10th to 90th $257 to $724
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 $323.59 Median $354.81 Typical High $354.81 | Professional | None | $323.59 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $1,905.46 | Facility | None | $660.69 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $707.95 | Professional | None | $269.15 | $416.87 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $588.84 | Professional | None | $416.87 | $489.78 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $7,943.28 | Facility | None | $501.19 | $812.83 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $707.95 | Professional | None | $354.81 | $426.58 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $537.03 | Facility | None | $309.03 | $501.19 | $537.03 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $1,258.93 Typical High $1,905.46 | Facility | None | $501.19 | $1,258.93 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $741.31 | Professional | None | $79.43 | $489.78 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $676.08 | Professional | None | $489.78 | $512.86 | $676.08 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $794.33 | Professional | None | $338.84 | $489.78 | $794.33 |
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 $162.18 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $64.57 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $48.98 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $263.03 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Where Oregon sits
The same service costs 6.0 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 $4,737MT $787
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.