How much rates vary
Facilitymedian $1,660 · 10th to 90th $955 to $5,012Professionalmedian $977 · 10th to 90th $417 to $2,291
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 $549.54 Median $4,265.80 Typical High $7,943.28 | Facility | None | $549.54 | $4,265.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $870.96 Typical High $1,288.25 | Professional | None | $363.08 | $870.96 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,235.94 Typical High $4,365.16 | Facility | None | $660.69 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $977.24 Typical High $2,398.83 | Professional | None | $489.78 | $977.24 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $2,137.96 | Professional | None | $575.44 | $870.96 | $2,137.96 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $1,778.28 Typical High $6,606.93 | Facility | None | $549.54 | $1,778.28 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $977.24 Typical High $1,819.70 | Professional | None | $380.19 | $977.24 | $1,819.70 |
Pacific Source Setting Facility Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $1,778.28 | Facility | None | $1,023.29 | $1,548.82 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $2,630.27 Typical High $4,365.16 | Facility | None | $616.60 | $2,630.27 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $933.25 Typical High $2,398.83 | Professional | None | $79.43 | $933.25 | $2,398.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $12,022.64 Typical High $13,803.84 | Facility | None | $8,912.51 | $12,022.64 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $645.65 Median $1,174.90 Typical High $2,344.23 | Professional | None | $645.65 | $1,174.90 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $588.84 Median $1,174.90 Typical High $2,398.83 | Professional | None | $588.84 | $1,174.90 | $2,398.83 |
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 $223.87 Median $245.47 Typical High $630.96 | Professional | 52 · Reduced service | $223.87 | $245.47 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $100.00 Typical High $251.19 | Professional | 53 · Discontinued | $89.13 | $100.00 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $933.25 | Professional | 54 · Surgery only | $331.13 | $371.54 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $186.21 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $50.12 Typical High $125.89 | Professional | 56 · Pre-op care only | $44.67 | $50.12 | $125.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $630.96 | Professional | 52 · Reduced service | $223.87 | $223.87 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $251.19 | Professional | 53 · Discontinued | $89.13 | $89.13 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $933.25 | Professional | 54 · Surgery only | $331.13 | $331.13 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $186.21 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $125.89 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $125.89 |
Where Oregon sits
The same service costs 3.7 times more in Wisconsin than in North Dakota. 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 $6,561ND $1,783
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.