How much rates vary
Facilitymedian $417 · 10th to 90th $209 to $537Professionalmedian $309 · 10th to 90th $186 to $525
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 Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | None | $186.21 | $186.21 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $416.87 | Facility | None | $169.82 | $302.00 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $549.54 | Professional | None | $204.17 | $346.74 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $645.65 | Professional | None | $263.03 | $380.19 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $616.60 | Facility | None | $208.93 | $346.74 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $478.63 | Professional | None | $186.21 | $309.03 | $478.63 |
Pacific Source Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $457.09 | Facility | None | $251.19 | $416.87 | $457.09 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $562.34 | Facility | None | $194.98 | $316.23 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $331.13 Typical High $549.54 | Professional | None | $79.43 | $331.13 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,047.13 | Facility | None | $691.83 | $933.25 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $467.74 | Professional | None | $263.03 | $416.87 | $467.74 |
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 $204.17 Median $331.13 Typical High $588.84 | Professional | None | $204.17 | $331.13 | $588.84 |
8 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 $93.33 Median $93.33 Typical High $154.88 | Professional | 52 · Reduced service | $93.33 | $93.33 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $154.88 | Professional | 52 · Reduced service | $93.33 | $93.33 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $38.02 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $30.90 |
Where Oregon sits
The same service costs 8.0 times more in New York 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
NY $2,495MD $313
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.