How much rates vary
Facilitymedian $1,096 · 10th to 90th $295 to $1,778Professionalmedian $490 · 10th to 90th $132 to $1,622
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 $117.49 Median $616.60 Typical High $1,000.00 | Professional | None | $117.49 | $616.60 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,000.00 Typical High $2,137.96 | Facility | None | $691.83 | $1,000.00 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $1,659.59 | Professional | None | $199.53 | $457.09 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $1,445.44 | Professional | None | $245.47 | $363.08 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $1,778.28 Typical High $7,943.28 | Facility | None | $275.42 | $1,778.28 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $467.74 Typical High $1,202.26 | Professional | None | $123.03 | $467.74 | $1,202.26 |
Pacific Source Setting Facility Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,380.38 | Facility | None | $794.33 | $1,096.48 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $954.99 Typical High $1,778.28 | Facility | None | $213.80 | $954.99 | $1,778.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $1,659.59 | Professional | None | $79.43 | $426.58 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $489.78 Typical High $1,737.80 | Professional | None | $269.15 | $489.78 | $1,737.80 |
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 $239.88 Median $776.25 Typical High $1,862.09 | Professional | None | $239.88 | $776.25 | $1,862.09 |
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 $95.50 Median $95.50 Typical High $478.63 | Professional | 52 · Reduced service | $95.50 | $95.50 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $190.55 | Professional | 53 · Discontinued | $38.90 | $38.90 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $707.95 | Professional | 54 · Surgery only | $144.54 | $144.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $141.25 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $95.50 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $478.63 | Professional | 52 · Reduced service | $95.50 | $95.50 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $190.55 | Professional | 53 · Discontinued | $38.90 | $38.90 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $707.95 | Professional | 54 · Surgery only | $144.54 | $144.54 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $141.25 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $95.50 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $95.50 |
Where Oregon sits
The same service costs 17.4 times more in Alabama 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
AL $9,157MT $526
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.