How much rates vary
Facilitymedian $1,995 · 10th to 90th $794 to $3,890Professionalmedian $380 · 10th to 90th $170 to $2,884
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 $3,890.45 Median $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $933.25 Typical High $2,089.30 | Professional | None | $158.49 | $933.25 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,412.54 Typical High $1,905.46 | Facility | None | $831.76 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $436.52 Typical High $3,235.94 | Professional | None | $169.82 | $436.52 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $3,019.95 | Professional | None | $199.53 | $302.00 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $3,019.95 Typical High $8,709.64 | Facility | None | $257.04 | $3,019.95 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $1,000.00 Typical High $2,454.71 | Professional | None | $173.78 | $1,000.00 | $2,454.71 |
Pacific Source Setting Facility Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $2,511.89 | Facility | None | $1,348.96 | $2,187.76 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $1,479.11 Typical High $3,019.95 | Facility | None | $295.12 | $1,479.11 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $346.74 Typical High $3,311.31 | Professional | None | $138.04 | $346.74 | $3,311.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,819.70 Median $4,466.84 Typical High $6,456.54 | Facility | None | $1,819.70 | $4,466.84 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $1,737.80 Typical High $2,511.89 | Professional | None | $223.87 | $1,737.80 | $2,511.89 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $199.53 Median $1,000.00 Typical High $3,235.94 | Professional | None | $199.53 | $1,000.00 | $3,235.94 |
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 $89.13 Median $501.19 Typical High $1,047.13 | Professional | 52 · Reduced service | $89.13 | $501.19 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $199.53 Typical High $416.87 | Professional | 53 · Discontinued | $35.48 | $199.53 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $758.58 Typical High $1,584.89 | Professional | 54 · Surgery only | $134.90 | $758.58 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $151.36 Typical High $316.23 | Professional | 55 · Aftercare only | $26.92 | $151.36 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $100.00 Typical High $208.93 | Professional | 56 · Pre-op care only | $17.78 | $100.00 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $323.59 Typical High $1,047.13 | Professional | 52 · Reduced service | $89.13 | $323.59 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $131.83 Typical High $416.87 | Professional | 53 · Discontinued | $35.48 | $131.83 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $489.78 Typical High $1,584.89 | Professional | 54 · Surgery only | $134.90 | $489.78 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $97.72 Typical High $316.23 | Professional | 55 · Aftercare only | $26.92 | $97.72 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $64.57 Typical High $208.93 | Professional | 56 · Pre-op care only | $17.78 | $64.57 | $208.93 |
Where Oregon sits
The same service costs 5.5 times more in Hawaii 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
HI $4,440MD $808
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.