How much rates vary
Facilitymedian $170 · 10th to 90th $93 to $912Professionalmedian $115 · 10th to 90th $59 to $282
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 $83.18 Median $3,235.94 Typical High $6,606.93 | Facility | None | $83.18 | $3,235.94 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $138.04 | Professional | None | $44.67 | $75.86 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $162.18 Typical High $660.69 | Facility | None | $128.82 | $162.18 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $295.12 | Professional | None | $93.33 | $141.25 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $309.03 | Professional | None | $109.65 | $165.96 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $173.78 Typical High $5,011.87 | Facility | None | $66.07 | $173.78 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $104.71 Typical High $223.87 | Professional | None | $45.71 | $104.71 | $223.87 |
Pacific Source Setting Facility Modifier None Typical Low $87.10 Median $147.91 Typical High $213.80 | Facility | None | $87.10 | $147.91 | $213.80 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $158.49 Typical High $660.69 | Facility | None | $93.33 | $158.49 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $288.40 | Professional | None | $79.43 | $120.23 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,258.93 | Facility | None | $812.83 | $1,122.02 | $1,258.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $288.40 | Professional | None | $85.11 | $194.98 | $288.40 |
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 $75.86 Median $141.25 Typical High $338.84 | Professional | None | $75.86 | $141.25 | $338.84 |
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 $22.91 Median $26.92 Typical High $56.23 | Professional | 52 · Reduced service | $22.91 | $26.92 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.72 Typical High $22.39 | Professional | 53 · Discontinued | $9.33 | $10.72 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $39.81 Typical High $83.18 | Professional | 54 · Surgery only | $34.67 | $39.81 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.94 Typical High $16.60 | Professional | 55 · Aftercare only | $6.92 | $7.94 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.37 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.57 | $5.37 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $23.44 Typical High $56.23 | Professional | 52 · Reduced service | $22.91 | $23.44 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $15.14 Typical High $22.39 | Professional | 53 · Discontinued | $9.33 | $15.14 | $22.39 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $34.67 Typical High $83.18 | Professional | 54 · Surgery only | $34.67 | $34.67 | $83.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $16.60 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $16.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.57 | $4.68 | $11.22 |
Where Oregon sits
The same service costs 16.4 times more in Connecticut than in Kentucky. 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
CT $2,728KY $166
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.