How much rates vary
Facilitymedian $575 · 10th to 90th $355 to $4,467Professionalmedian $437 · 10th to 90th $245 to $776
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 $316.23 Median $5,623.41 Typical High $8,709.64 | Facility | None | $316.23 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $446.68 | Professional | None | $186.21 | $257.04 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,137.96 | Facility | None | $891.25 | $1,621.81 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $812.83 | Professional | None | $245.47 | $436.52 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $794.33 | Professional | None | $302.00 | $457.09 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $645.65 Typical High $7,943.28 | Facility | None | $316.23 | $645.65 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $616.60 | Professional | None | $239.88 | $389.05 | $616.60 |
Pacific Source Setting Facility Modifier None Typical Low $323.59 Median $537.03 Typical High $616.60 | Facility | None | $323.59 | $537.03 | $616.60 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,288.25 Typical High $2,137.96 | Facility | None | $416.87 | $1,288.25 | $2,137.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $436.52 Typical High $794.33 | Professional | None | $79.43 | $436.52 | $794.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,265.80 Median $5,888.44 Typical High $6,918.31 | Facility | None | $4,265.80 | $5,888.44 | $6,918.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $776.25 | Professional | None | $331.13 | $562.34 | $776.25 |
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 $295.12 Median $478.63 Typical High $831.76 | Professional | None | $295.12 | $478.63 | $831.76 |
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 $128.82 Median $128.82 Typical High $223.87 | Professional | 52 · Reduced service | $128.82 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $89.13 | Professional | 53 · Discontinued | $52.48 | $52.48 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $338.84 | Professional | 54 · Surgery only | $194.98 | $194.98 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $67.61 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $223.87 | Professional | 52 · Reduced service | $128.82 | $128.82 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $89.13 | Professional | 53 · Discontinued | $52.48 | $52.48 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $338.84 | Professional | 54 · Surgery only | $194.98 | $194.98 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $67.61 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $44.67 |
Where Oregon sits
The same service costs 7.0 times more in Vermont than in North Dakota. 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
VT $4,790ND $687
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.