How much rates vary
Facilitymedian $2,512 · 10th to 90th $562 to $10,233Professionalmedian $617 · 10th to 90th $269 to $3,467
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 $331.13 Median $2,884.03 Typical High $13,182.57 | Facility | None | $331.13 | $2,884.03 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $2,187.76 | Professional | None | $269.15 | $371.54 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,235.94 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $707.95 Typical High $3,715.35 | Professional | None | $331.13 | $707.95 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $3,162.28 | Professional | None | $380.19 | $588.84 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $8,317.64 Typical High $12,022.64 | Facility | None | $524.81 | $8,317.64 | $12,022.64 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $2,818.38 | Professional | None | $269.15 | $537.03 | $2,818.38 |
Pacific Source Setting Facility Modifier None Typical Low $489.78 Median $2,290.87 Typical High $2,630.27 | Facility | None | $489.78 | $2,290.87 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $2,884.03 Typical High $4,466.84 | Facility | None | $562.34 | $2,884.03 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $616.60 Typical High $3,630.78 | Professional | None | $79.43 | $616.60 | $3,630.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,715.19 Typical High $12,589.25 | Facility | None | $7,413.10 | $10,715.19 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $3,548.13 | Professional | None | $436.52 | $794.33 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $12,302.69 | Facility | None | $1,230.27 | $2,041.74 | $12,302.69 |
United Setting Professional Modifier None Typical Low $380.19 Median $794.33 Typical High $3,801.89 | Professional | None | $380.19 | $794.33 | $3,801.89 |
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 $131.83 Median $173.78 Typical High $891.25 | Professional | 52 · Reduced service | $131.83 | $173.78 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $354.81 | Professional | 53 · Discontinued | $53.70 | $69.18 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $1,348.96 | Professional | 54 · Surgery only | $199.53 | $263.03 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $269.15 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $177.83 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $134.90 Typical High $891.25 | Professional | 52 · Reduced service | $131.83 | $134.90 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $74.13 Typical High $354.81 | Professional | 53 · Discontinued | $53.70 | $74.13 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $1,348.96 | Professional | 54 · Surgery only | $199.53 | $199.53 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $269.15 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $177.83 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $177.83 |
Where Oregon sits
The same service costs 4.3 times more in Vermont than in Maine. 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
VT $8,043ME $1,891
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.