How much rates vary
Facilitymedian $692 · 10th to 90th $513 to $10,471Professionalmedian $603 · 10th to 90th $331 to $891
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 $5,128.61 Median $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $489.78 | Professional | None | $398.11 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,943.28 Typical High $10,964.78 | Facility | None | $1,000.00 | $7,943.28 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $870.96 | Professional | None | $389.05 | $512.86 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $758.58 | Professional | None | $489.78 | $630.96 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $17,378.01 | Facility | None | $660.69 | $1,000.00 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $812.83 | Professional | None | $489.78 | $524.81 | $812.83 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $630.96 Typical High $707.95 | Facility | None | $436.52 | $630.96 | $707.95 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $7,244.36 Typical High $10,964.78 | Facility | None | $691.83 | $7,244.36 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $602.56 Typical High $954.99 | Professional | None | $79.43 | $602.56 | $954.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,022.64 Typical High $15,135.61 | Facility | None | $9,332.54 | $12,022.64 | $15,135.61 |
Regence BlueShield Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $870.96 | Professional | None | $616.60 | $645.65 | $870.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,023.29 | Professional | None | $489.78 | $616.60 | $1,023.29 |
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 $199.53 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $79.43 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $39.81 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $323.59 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $48.98 |
Where Oregon sits
The same service costs 7.2 times more in Wisconsin 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
WI $7,422MT $1,038
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.