How much rates vary
Facilitymedian $288 · 10th to 90th $174 to $2,884Professionalmedian $195 · 10th to 90th $110 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 $181.97 Median $4,677.35 Typical High $7,943.28 | Facility | None | $181.97 | $4,677.35 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $204.17 | Professional | None | $97.72 | $144.54 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $977.24 Typical High $1,230.27 | Facility | None | $741.31 | $977.24 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $338.84 | Professional | None | $112.20 | $194.98 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $371.54 | Professional | None | $147.91 | $213.80 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $309.03 Typical High $7,943.28 | Facility | None | $154.88 | $309.03 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $281.84 | Professional | None | $109.65 | $181.97 | $281.84 |
Pacific Source Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $295.12 | Facility | None | $169.82 | $257.04 | $295.12 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $870.96 Typical High $1,318.26 | Facility | None | $204.17 | $870.96 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $354.81 | Professional | None | $107.15 | $194.98 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $3,630.78 | Facility | None | $1,819.70 | $2,754.23 | $3,630.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $275.42 | Professional | None | $151.36 | $251.19 | $275.42 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $354.81 | Professional | None | $125.89 | $213.80 | $354.81 |
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 $54.95 Median $61.66 Typical High $100.00 | Professional | 52 · Reduced service | $54.95 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $24.55 Typical High $40.74 | Professional | 53 · Discontinued | $21.88 | $24.55 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $93.33 Typical High $151.36 | Professional | 54 · Surgery only | $81.28 | $93.33 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $18.62 Typical High $30.20 | Professional | 55 · Aftercare only | $16.22 | $18.62 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.30 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.96 | $12.30 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $100.00 | Professional | 52 · Reduced service | $54.95 | $54.95 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $40.74 | Professional | 53 · Discontinued | $21.88 | $21.88 | $40.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $151.36 | Professional | 54 · Surgery only | $81.28 | $81.28 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $30.20 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $20.42 |
Where Oregon sits
The same service costs 8.0 times more in New York than in North Dakota. 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 $2,762ND $346
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.