How much rates vary
Facilitymedian $195 · 10th to 90th $123 to $427Professionalmedian $186 · 10th to 90th $105 to $282
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 $104.71 Median $151.36 Typical High $151.36 | Professional | None | $104.71 | $151.36 | $151.36 |
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 $128.82 Median $162.18 Typical High $275.42 | Professional | None | $128.82 | $162.18 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $234.42 | Professional | None | $165.96 | $190.55 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $281.84 Typical High $7,943.28 | Facility | None | $165.96 | $281.84 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $295.12 | Professional | None | $134.90 | $158.49 | $295.12 |
Pacific Source Setting Facility Modifier None Typical Low $123.03 Median $194.98 Typical High $204.17 | Facility | None | $123.03 | $194.98 | $204.17 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $245.47 Typical High $758.58 | Facility | None | $144.54 | $245.47 | $758.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $302.00 | Professional | None | $79.43 | $190.55 | $302.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $269.15 | Professional | None | $194.98 | $204.17 | $269.15 |
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 $154.88 Median $190.55 Typical High $323.59 | Professional | None | $154.88 | $190.55 | $323.59 |
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 $56.23 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $56.23 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $22.39 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $83.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $69.18 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $27.54 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $102.33 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $20.42 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $13.80 | $15.14 | $15.14 |
Where Oregon sits
The same service costs 13.9 times more in Utah than in Delaware. 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
UT $3,071DE $220
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.