How much rates vary
Facilitymedian $331 · 10th to 90th $200 to $2,692Professionalmedian $240 · 10th to 90th $151 to $389
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 $186.21 Median $4,677.35 Typical High $7,943.28 | Facility | None | $186.21 | $4,677.35 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $239.88 | Professional | None | $117.49 | $158.49 | $239.88 |
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 $245.47 Typical High $407.38 | Professional | None | $162.18 | $245.47 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $436.52 | Professional | None | $199.53 | $288.40 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $1,548.82 Typical High $5,011.87 | Facility | None | $218.78 | $1,548.82 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $346.74 | Professional | None | $151.36 | $239.88 | $346.74 |
Pacific Source Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $338.84 | Facility | None | $194.98 | $323.59 | $338.84 |
Providence Setting Facility Modifier None Typical Low $239.88 Median $660.69 Typical High $1,000.00 | Facility | None | $239.88 | $660.69 | $1,000.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $407.38 | Professional | None | $79.43 | $245.47 | $407.38 |
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 $213.80 Median $316.23 Typical High $338.84 | Professional | None | $213.80 | $316.23 | $338.84 |
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 $169.82 Median $269.15 Typical High $436.52 | Professional | None | $169.82 | $269.15 | $436.52 |
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 $75.86 Median $75.86 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $23.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $75.86 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $30.20 | $47.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $114.82 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $23.99 |
Where Oregon sits
The same service costs 6.3 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 $2,712MT $427
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.