How much rates vary
Facilitymedian $1,514 · 10th to 90th $302 to $1,995Professionalmedian $550 · 10th to 90th $191 to $2,188
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 $275.42 Median $4,265.80 Typical High $7,943.28 | Facility | None | $275.42 | $4,265.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $831.76 Typical High $1,513.56 | Professional | None | $162.18 | $831.76 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $758.58 Typical High $2,511.89 | Facility | None | $660.69 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $549.54 Typical High $2,344.23 | Professional | None | $257.04 | $549.54 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $2,041.74 | Professional | None | $295.12 | $436.52 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $1,288.25 Typical High $6,606.93 | Facility | None | $275.42 | $1,288.25 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $549.54 Typical High $1,621.81 | Professional | None | $169.82 | $549.54 | $1,621.81 |
Pacific Source Setting Facility Modifier None Typical Low $977.24 Median $1,548.82 Typical High $1,698.24 | Facility | None | $977.24 | $1,548.82 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $1,047.13 Typical High $2,137.96 | Facility | None | $257.04 | $1,047.13 | $2,137.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $467.74 Typical High $2,290.87 | Professional | None | $79.43 | $467.74 | $2,290.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $2,454.71 | Professional | None | $323.59 | $575.44 | $2,454.71 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $309.03 Median $1,071.52 Typical High $2,454.71 | Professional | None | $309.03 | $1,071.52 | $2,454.71 |
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 $112.20 Median $134.90 Typical High $645.65 | Professional | 52 · Reduced service | $112.20 | $134.90 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $53.70 Typical High $257.04 | Professional | 53 · Discontinued | $45.71 | $53.70 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $204.17 Typical High $954.99 | Professional | 54 · Surgery only | $169.82 | $204.17 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $190.55 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.92 Typical High $128.82 | Professional | 56 · Pre-op care only | $22.91 | $26.92 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $645.65 | Professional | 52 · Reduced service | $112.20 | $112.20 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $257.04 | Professional | 53 · Discontinued | $45.71 | $45.71 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $954.99 | Professional | 54 · Surgery only | $169.82 | $169.82 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $190.55 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $128.82 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $128.82 |
Where Oregon sits
The same service costs 11.7 times more in Vermont 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
VT $7,161MD $610
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.