How much rates vary
Facilitymedian $631 · 10th to 90th $380 to $5,129Professionalmedian $479 · 10th to 90th $263 to $912
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 $323.59 Median $5,623.41 Typical High $8,709.64 | Facility | None | $323.59 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $467.74 | Professional | None | $229.09 | $288.40 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,905.46 Typical High $2,570.40 | Facility | None | $891.25 | $1,905.46 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $954.99 | Professional | None | $288.40 | $501.19 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $794.33 | Professional | None | $338.84 | $512.86 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $616.60 Typical High $7,943.28 | Facility | None | $323.59 | $616.60 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $645.65 | Professional | None | $263.03 | $416.87 | $645.65 |
Pacific Source Setting Facility Modifier None Typical Low $371.54 Median $549.54 Typical High $691.83 | Facility | None | $371.54 | $549.54 | $691.83 |
Providence Setting Facility Modifier None Typical Low $489.78 Median $1,513.56 Typical High $2,570.40 | Facility | None | $489.78 | $1,513.56 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $501.19 Typical High $954.99 | Professional | None | $79.43 | $501.19 | $954.99 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $8,128.31 | Facility | None | $5,248.07 | $7,244.36 | $8,128.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $645.65 Typical High $933.25 | Professional | None | $380.19 | $645.65 | $933.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,022.64 | Facility | None | $1,230.27 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $954.99 | Professional | None | $338.84 | $537.03 | $954.99 |
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 $128.82 Median $144.54 Typical High $234.42 | Professional | 52 · Reduced service | $128.82 | $144.54 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $93.33 | Professional | 53 · Discontinued | $52.48 | $57.54 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $354.81 | Professional | 54 · Surgery only | $194.98 | $213.80 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $70.79 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $234.42 | Professional | 52 · Reduced service | $128.82 | $128.82 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $93.33 | Professional | 53 · Discontinued | $52.48 | $52.48 | $93.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $354.81 | Professional | 54 · Surgery only | $194.98 | $194.98 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $70.79 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $46.77 |
Where Oregon sits
The same service costs 7.9 times more in Oklahoma 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
OK $5,867MT $745
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.