How much rates vary
Facilitymedian $282 · 10th to 90th $174 to $2,951Professionalmedian $200 · 10th to 90th $115 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 $114.82 Median $138.04 Typical High $199.53 | Professional | None | $114.82 | $138.04 | $199.53 |
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 $120.23 Median $199.53 Typical High $338.84 | Professional | None | $120.23 | $199.53 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $389.05 | Professional | None | $162.18 | $239.88 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $371.54 Typical High $7,943.28 | Facility | None | $165.96 | $371.54 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $288.40 | Professional | None | $114.82 | $199.53 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $295.12 | Facility | None | $169.82 | $269.15 | $295.12 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $870.96 Typical High $1,318.26 | Facility | None | $213.80 | $870.96 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $363.08 | Professional | None | $109.65 | $199.53 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $3,630.78 | Facility | None | $2,290.87 | $3,162.28 | $3,630.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $275.42 | Professional | None | $162.18 | $257.04 | $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 $131.83 Median $218.78 Typical High $371.54 | Professional | None | $131.83 | $218.78 | $371.54 |
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 $57.54 Median $64.57 Typical High $100.00 | Professional | 52 · Reduced service | $57.54 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $39.81 | Professional | 53 · Discontinued | $23.44 | $25.70 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $97.72 Typical High $151.36 | Professional | 54 · Surgery only | $87.10 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.50 Typical High $30.20 | Professional | 55 · Aftercare only | $17.38 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.88 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.48 | $12.88 | $19.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $57.54 Typical High $100.00 | Professional | 52 · Reduced service | $57.54 | $57.54 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $39.81 | Professional | 53 · Discontinued | $23.44 | $23.44 | $39.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $151.36 | Professional | 54 · Surgery only | $87.10 | $87.10 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $30.20 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $19.95 |
Where Oregon sits
The same service costs 7.8 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 $2,820ND $362
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.