How much rates vary
Facilitymedian $214 · 10th to 90th $120 to $2,291Professionalmedian $166 · 10th to 90th $102 to $288
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 $77.62 Median $104.71 Typical High $154.88 | Professional | None | $77.62 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $107.15 Typical High $660.69 | Facility | None | $85.11 | $107.15 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $302.00 | Professional | None | $107.15 | $181.97 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $263.03 | Professional | None | $123.03 | $173.78 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $269.15 Typical High $6,606.93 | Facility | None | $151.36 | $269.15 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $229.09 | Professional | None | $100.00 | $154.88 | $229.09 |
Pacific Source Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $218.78 | Facility | None | $128.82 | $213.80 | $218.78 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $660.69 | Facility | None | $87.10 | $134.90 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $295.12 | Professional | None | $79.43 | $177.83 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $2,818.38 | Facility | None | $1,819.70 | $2,454.71 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $295.12 | Professional | None | $144.54 | $208.93 | $295.12 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,630.78 | Facility | None | $354.81 | $660.69 | $3,630.78 |
United Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $323.59 | Professional | None | $131.83 | $199.53 | $323.59 |
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 $52.48 Median $52.48 Typical High $77.62 | Professional | 52 · Reduced service | $52.48 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $30.90 | Professional | 53 · Discontinued | $21.38 | $21.38 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $117.49 | Professional | 54 · Surgery only | $79.43 | $79.43 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $23.44 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $77.62 | Professional | 52 · Reduced service | $52.48 | $52.48 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $30.90 | Professional | 53 · Discontinued | $21.38 | $21.38 | $30.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $117.49 | Professional | 54 · Surgery only | $79.43 | $79.43 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $23.44 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $15.49 |
Where Oregon sits
The same service costs 12.3 times more in Connecticut 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
CT $2,823WV $230
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.