How much rates vary
Facilitymedian $69 · 10th to 90th $51 to $813Professionalmedian $66 · 10th to 90th $45 to $98
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 $31.62 Median $51.29 Typical High $51.29 | Professional | None | $31.62 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $269.15 Typical High $660.69 | Facility | None | $213.80 | $269.15 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $93.33 | Professional | None | $47.86 | $63.10 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $77.62 | Professional | None | $56.23 | $66.07 | $77.62 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $7,943.28 | Facility | None | $66.07 | $95.50 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $89.13 | Professional | None | $33.88 | $51.29 | $89.13 |
Pacific Source Setting Facility Modifier None Typical Low $42.66 Median $66.07 Typical High $74.13 | Facility | None | $42.66 | $66.07 | $74.13 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $251.19 Typical High $707.95 | Facility | None | $74.13 | $251.19 | $707.95 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $102.33 | Professional | None | $48.98 | $77.62 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $912.01 | Facility | None | $602.56 | $812.83 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $104.71 | Professional | None | $66.07 | $69.18 | $104.71 |
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 $51.29 Median $72.44 Typical High $117.49 | Professional | None | $51.29 | $72.44 | $117.49 |
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 $20.42 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $20.42 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $8.13 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 54 · Surgery only | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.03 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.07 | $5.13 | $5.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 54 · Surgery only | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Where Oregon sits
The same service costs 24.8 times more in New York 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
NY $2,664MT $107
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.