How much rates vary
Facilitymedian $151 · 10th to 90th $102 to $2,399Professionalmedian $138 · 10th to 90th $79 to $204
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 $177.83 Median $5,011.87 Typical High $7,943.28 | Facility | None | $177.83 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $109.65 | Professional | None | $83.18 | $85.11 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,174.90 Typical High $1,584.89 | Facility | None | $660.69 | $1,174.90 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $123.03 Typical High $204.17 | Professional | None | $77.62 | $123.03 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $190.55 | Professional | None | $134.90 | $162.18 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $257.04 Typical High $7,943.28 | Facility | None | $123.03 | $257.04 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $245.47 | Professional | None | $85.11 | $120.23 | $245.47 |
Pacific Source Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $151.36 | Facility | None | $91.20 | $128.82 | $151.36 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $1,071.52 Typical High $1,584.89 | Facility | None | $173.78 | $1,071.52 | $1,584.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $204.17 | Professional | None | $79.43 | $141.25 | $204.17 |
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 $144.54 Median $151.36 Typical High $204.17 | Professional | None | $144.54 | $151.36 | $204.17 |
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 $85.11 Median $123.03 Typical High $218.78 | Professional | None | $85.11 | $123.03 | $218.78 |
11 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 $38.90 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $38.90 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $15.49 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 54 · Surgery only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 54 · Surgery only | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $3,388.44 Median $4,786.30 Typical High $5,495.41 | Facility | 50 · Both sides | $3,388.44 | $4,786.30 | $5,495.41 |
Where Oregon sits
The same service costs 12.2 times more in Connecticut 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
CT $2,815MT $231
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.