How much rates vary
Facilitymedian $214 · 10th to 90th $148 to $2,239Professionalmedian $204 · 10th to 90th $110 to $324
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 $109.65 Median $141.25 Typical High $141.25 | Professional | None | $109.65 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $741.31 Typical High $1,000.00 | Facility | None | $537.03 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $302.00 | Professional | None | $162.18 | $204.17 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $269.15 | Professional | None | $190.55 | $218.78 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $7,943.28 | Facility | None | $194.98 | $354.81 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $302.00 | Professional | None | $117.49 | $173.78 | $302.00 |
Pacific Source Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $223.87 | Facility | None | $125.89 | $204.17 | $223.87 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $691.83 Typical High $1,047.13 | Facility | None | $251.19 | $691.83 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $204.17 Typical High $323.59 | Professional | None | $79.43 | $204.17 | $323.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $2,818.38 | Facility | None | $1,819.70 | $2,398.83 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $331.13 | Professional | None | $208.93 | $223.87 | $331.13 |
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 $158.49 Median $218.78 Typical High $398.11 | Professional | None | $158.49 | $218.78 | $398.11 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $104.71 | $104.71 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Where Oregon sits
The same service costs 8.1 times more in New York than in Montana. 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 $2,852MT $352
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.