How much rates vary
Facilitymedian $316 · 10th to 90th $186 to $661Professionalmedian $245 · 10th to 90th $126 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 $100.00 Median $151.36 Typical High $245.47 | Professional | None | $100.00 | $151.36 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $213.80 Typical High $302.00 | Facility | None | $120.23 | $213.80 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $457.09 | Professional | None | $128.82 | $245.47 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $501.19 | Professional | None | $165.96 | $218.78 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $588.84 Typical High $6,606.93 | Facility | None | $223.87 | $588.84 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $398.11 | Professional | None | $125.89 | $208.93 | $398.11 |
Pacific Source Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $346.74 | Facility | None | $194.98 | $316.23 | $346.74 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $229.09 Typical High $446.68 | Facility | None | $125.89 | $229.09 | $446.68 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $446.68 | Professional | None | $79.43 | $245.47 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $794.33 | Facility | None | $524.81 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $346.74 | Professional | None | $177.83 | $323.59 | $346.74 |
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 $151.36 Median $263.03 Typical High $467.74 | Professional | None | $151.36 | $263.03 | $467.74 |
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 $123.03 | Professional | 52 · Reduced service | $63.10 | $63.10 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $48.98 | Professional | 53 · Discontinued | $25.12 | $25.12 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $181.97 | Professional | 54 · Surgery only | $95.50 | $95.50 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $36.31 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $24.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $63.10 Typical High $123.03 | Professional | 52 · Reduced service | $63.10 | $63.10 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $48.98 | Professional | 53 · Discontinued | $25.12 | $25.12 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $181.97 | Professional | 54 · Surgery only | $95.50 | $95.50 | $181.97 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $36.31 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $36.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $24.55 |
Where Oregon sits
The same service costs 11.6 times more in Hawaii 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
HI $3,027MD $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.