How much rates vary
Facilitymedian $794 · 10th to 90th $468 to $8,318Professionalmedian $550 · 10th to 90th $257 to $1,122
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 $316.23 Median $7,943.28 Typical High $17,378.01 | Facility | None | $316.23 | $7,943.28 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $549.54 | Professional | None | $257.04 | $338.84 | $549.54 |
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 $316.23 Median $602.56 Typical High $1,148.15 | Professional | None | $316.23 | $602.56 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $954.99 | Professional | None | $363.08 | $562.34 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $1,122.02 Typical High $13,182.57 | Facility | None | $363.08 | $1,122.02 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $831.76 | Professional | None | $257.04 | $446.68 | $831.76 |
Pacific Source Setting Facility Modifier None Typical Low $457.09 Median $724.44 Typical High $870.96 | Facility | None | $457.09 | $724.44 | $870.96 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $2,630.27 Typical High $4,466.84 | Facility | None | $501.19 | $2,630.27 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $588.84 Typical High $1,174.90 | Professional | None | $79.43 | $588.84 | $1,174.90 |
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 $426.58 Median $707.95 Typical High $1,148.15 | Professional | None | $426.58 | $707.95 | $1,148.15 |
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 $371.54 Median $645.65 Typical High $1,174.90 | Professional | None | $371.54 | $645.65 | $1,174.90 |
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 $190.55 Typical High $257.04 | Professional | 52 · Reduced service | $128.82 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $75.86 Typical High $102.33 | Professional | 53 · Discontinued | $51.29 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $190.55 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $56.23 Typical High $77.62 | Professional | 55 · Aftercare only | $38.02 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.02 Typical High $51.29 | Professional | 56 · Pre-op care only | $25.70 | $38.02 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $144.54 Typical High $257.04 | Professional | 52 · Reduced service | $128.82 | $144.54 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $51.29 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $218.78 Typical High $389.05 | Professional | 54 · Surgery only | $190.55 | $218.78 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $43.65 Typical High $77.62 | Professional | 55 · Aftercare only | $38.02 | $43.65 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $51.29 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $51.29 |
Where Oregon sits
The same service costs 5.9 times more in Oklahoma than in West Virginia. 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 $4,893WV $835
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.