How much rates vary
Facilitymedian $8,511 · 10th to 90th $5,129 to $16,982Professionalmedian $1,380 · 10th to 90th $550 to $12,589
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 $691.83 Median $8,912.51 Typical High $17,378.01 | Facility | None | $691.83 | $8,912.51 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $4,265.80 Typical High $8,511.38 | Professional | None | $416.87 | $4,265.80 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $12,882.50 Typical High $17,378.01 | Facility | None | $870.96 | $12,882.50 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,348.96 Typical High $13,182.57 | Professional | None | $602.56 | $1,348.96 | $13,182.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $11,220.18 | Professional | None | $707.95 | $1,071.52 | $11,220.18 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $8,912.51 Typical High $17,378.01 | Facility | None | $691.83 | $8,912.51 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $4,265.80 Typical High $9,332.54 | Professional | None | $467.74 | $4,265.80 | $9,332.54 |
Pacific Source Setting Facility Modifier None Typical Low $5,623.41 Median $8,511.38 Typical High $9,332.54 | Facility | None | $5,623.41 | $8,511.38 | $9,332.54 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $11,748.98 Typical High $16,218.10 | Facility | None | $812.83 | $11,748.98 | $16,218.10 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,230.27 Typical High $12,882.50 | Professional | None | $79.43 | $1,230.27 | $12,882.50 |
Regence BlueShield Setting Facility Modifier None Typical Low $29,512.09 Median $39,810.72 Typical High $45,708.82 | Facility | None | $29,512.09 | $39,810.72 | $45,708.82 |
Regence BlueShield Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $13,489.63 | Professional | None | $794.33 | $1,445.44 | $13,489.63 |
United Setting Facility Modifier None Typical Low $2,951.21 Median $6,918.31 Typical High $50,118.72 | Facility | None | $2,951.21 | $6,918.31 | $50,118.72 |
United Setting Professional Modifier None Typical Low $794.33 Median $5,888.44 Typical High $13,803.84 | Professional | None | $794.33 | $5,888.44 | $13,803.84 |
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 $281.84 Median $338.84 Typical High $3,630.78 | Professional | 52 · Reduced service | $281.84 | $338.84 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $1,445.44 | Professional | 53 · Discontinued | $112.20 | $134.90 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $5,370.32 | Professional | 54 · Surgery only | $426.58 | $512.86 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $1,071.52 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $724.44 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $3,630.78 | Professional | 52 · Reduced service | $281.84 | $281.84 | $3,630.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $1,445.44 | Professional | 53 · Discontinued | $112.20 | $112.20 | $1,445.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $5,370.32 | Professional | 54 · Surgery only | $426.58 | $426.58 | $5,370.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $1,071.52 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $1,071.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $724.44 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $724.44 |
Where Oregon sits
The same service costs 4.3 times more in Alabama than in Maine. 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 $20,420ME $4,758
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.