How much rates vary
Facilitymedian $389 · 10th to 90th $234 to $851Professionalmedian $331 · 10th to 90th $186 to $589
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 $147.91 Median $218.78 Typical High $316.23 | Professional | None | $147.91 | $218.78 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $660.69 | Facility | None | $223.87 | $288.40 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $616.60 | Professional | None | $190.55 | $331.13 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $602.56 | Professional | None | $245.47 | $371.54 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $489.78 Typical High $6,606.93 | Facility | None | $269.15 | $489.78 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $436.52 | Professional | None | $186.21 | $302.00 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $245.47 Median $389.05 Typical High $436.52 | Facility | None | $245.47 | $389.05 | $436.52 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $323.59 Typical High $676.08 | Facility | None | $223.87 | $323.59 | $676.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $331.13 Typical High $602.56 | Professional | None | $79.43 | $331.13 | $602.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Facility | None | $691.83 | $851.14 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $426.58 Typical High $588.84 | Professional | None | $257.04 | $426.58 | $588.84 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $645.65 | Professional | None | $223.87 | $363.08 | $645.65 |
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 $93.33 Median $93.33 Typical High $158.49 | Professional | 52 · Reduced service | $93.33 | $93.33 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $63.10 | Professional | 53 · Discontinued | $37.15 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $239.88 | Professional | 54 · Surgery only | $141.25 | $141.25 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $47.86 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $158.49 | Professional | 52 · Reduced service | $93.33 | $93.33 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $63.10 | Professional | 53 · Discontinued | $37.15 | $37.15 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $239.88 | Professional | 54 · Surgery only | $141.25 | $141.25 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $47.86 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $31.62 |
Where Oregon sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.