How much rates vary
Facilitymedian $234 · 10th to 90th $158 to $1,023Professionalmedian $224 · 10th to 90th $117 to $339
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 $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $346.74 Typical High $660.69 | Facility | None | $275.42 | $346.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $316.23 | Professional | None | $165.96 | $213.80 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $251.19 | Professional | None | $181.97 | $213.80 | $251.19 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $7,943.28 | Facility | None | $218.78 | $371.54 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $309.03 | Professional | None | $158.49 | $199.53 | $309.03 |
Pacific Source Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $239.88 | Facility | None | $144.54 | $223.87 | $239.88 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $338.84 Typical High $676.08 | Facility | None | $186.21 | $338.84 | $676.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $338.84 | Professional | None | $79.43 | $223.87 | $338.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,174.90 | Facility | None | $776.25 | $1,023.29 | $1,174.90 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $346.74 | Professional | None | $223.87 | $234.42 | $346.74 |
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 $181.97 Median $257.04 Typical High $398.11 | Professional | None | $181.97 | $257.04 | $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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Oregon sits
The same service costs 8.9 times more in New York than in Maryland. 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 $2,750MD $308
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.