How much rates vary
Facilitymedian $275 · 10th to 90th $166 to $1,288Professionalmedian $234 · 10th to 90th $141 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 $173.78 Median $4,786.30 Typical High $7,943.28 | Facility | None | $173.78 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $281.84 | Professional | None | $141.25 | $190.55 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $389.05 | Professional | None | $144.54 | $208.93 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $346.74 | Professional | None | $162.18 | $218.78 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $457.09 Typical High $6,606.93 | Facility | None | $173.78 | $457.09 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $446.68 | Professional | None | $141.25 | $229.09 | $446.68 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $275.42 Typical High $426.58 | Facility | None | $165.96 | $275.42 | $426.58 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $575.44 | Facility | None | $100.00 | $371.54 | $575.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $263.03 Typical High $416.87 | Professional | None | $79.43 | $263.03 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,621.81 | Facility | None | $1,023.29 | $1,380.38 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $331.13 | Professional | None | $194.98 | $269.15 | $331.13 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $436.52 | Professional | None | $162.18 | $263.03 | $436.52 |
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 $70.79 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $70.79 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $31.62 Typical High $40.74 | Professional | 53 · Discontinued | $28.18 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $117.49 Typical High $151.36 | Professional | 54 · Surgery only | $107.15 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.44 Typical High $30.20 | Professional | 55 · Aftercare only | $21.38 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $75.86 Typical High $102.33 | Professional | 52 · Reduced service | $70.79 | $75.86 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.20 Typical High $40.74 | Professional | 53 · Discontinued | $28.18 | $30.20 | $40.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $107.15 | $112.20 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.14 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.13 | $15.14 | $20.42 |
Where Oregon sits
The same service costs 11.5 times more in Connecticut than in Maryland. 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
CT $2,992MD $261
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.