How much rates vary
Facilitymedian $661 · 10th to 90th $398 to $5,129Professionalmedian $490 · 10th to 90th $269 to $851
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $489.78 | Professional | None | $204.17 | $309.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,089.30 Typical High $2,884.03 | Facility | None | $691.83 | $2,089.30 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $912.01 | Professional | None | $316.23 | $501.19 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $870.96 | Professional | None | $354.81 | $478.63 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $776.25 Typical High $8,709.64 | Facility | None | $436.52 | $776.25 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $389.05 Typical High $707.95 | Professional | None | $223.87 | $389.05 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $630.96 Typical High $691.83 | Facility | None | $398.11 | $630.96 | $691.83 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $2,884.03 | Facility | None | $537.03 | $1,862.09 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $501.19 Typical High $891.25 | Professional | None | $79.43 | $501.19 | $891.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $7,413.10 | Facility | None | $4,786.30 | $6,456.54 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $707.95 | Professional | None | $416.87 | $630.96 | $707.95 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $912.01 | Professional | None | $338.84 | $562.34 | $912.01 |
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 $123.03 Median $154.88 Typical High $245.47 | Professional | 52 · Reduced service | $123.03 | $154.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $61.66 Typical High $97.72 | Professional | 53 · Discontinued | $48.98 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $229.09 Typical High $371.54 | Professional | 54 · Surgery only | $181.97 | $229.09 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $45.71 Typical High $74.13 | Professional | 55 · Aftercare only | $36.31 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $24.55 | $30.90 | $48.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $154.88 Typical High $245.47 | Professional | 52 · Reduced service | $123.03 | $154.88 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $61.66 Typical High $97.72 | Professional | 53 · Discontinued | $48.98 | $61.66 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $229.09 Typical High $371.54 | Professional | 54 · Surgery only | $181.97 | $229.09 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $45.71 Typical High $74.13 | Professional | 55 · Aftercare only | $36.31 | $45.71 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $24.55 | $30.90 | $48.98 |
Where Oregon sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.