How much rates vary
Facilitymedian $603 · 10th to 90th $331 to $3,162Professionalmedian $407 · 10th to 90th $240 to $776
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 $295.12 Median $3,890.45 Typical High $7,943.28 | Facility | None | $295.12 | $3,890.45 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $467.74 | Professional | None | $190.55 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $93.33 Typical High $194.98 | Professional | 53 · Discontinued | $47.86 | $93.33 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $562.34 Typical High $891.25 | Facility | None | $537.03 | $562.34 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
HealthNet Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $912.01 | Professional | None | $316.23 | $478.63 | $912.01 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $524.81 Typical High $933.25 | Professional | 53 · Discontinued | $316.23 | $524.81 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $1,778.28 Typical High $6,025.60 | Facility | None | $354.81 | $1,778.28 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $776.25 | Professional | None | $239.88 | $446.68 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $93.33 Typical High $208.93 | Professional | 53 · Discontinued | $47.86 | $93.33 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $309.03 Median $562.34 Typical High $676.08 | Facility | None | $309.03 | $562.34 | $676.08 |
Pacific Source Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $645.65 | Professional | None | $177.83 | $331.13 | $645.65 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $891.25 Typical High $1,318.26 | Facility | None | $416.87 | $891.25 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $933.25 | Professional | None | $288.40 | $398.11 | $933.25 |
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 $295.12 Median $537.03 Typical High $691.83 | Professional | None | $295.12 | $537.03 | $691.83 |
Regence BlueShield Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $269.15 Typical High $316.23 | Professional | 53 · Discontinued | $147.91 | $269.15 | $316.23 |
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 $309.03 Median $512.86 Typical High $891.25 | Professional | None | $309.03 | $512.86 | $891.25 |
8 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 $93.33 Median $120.23 Typical High $147.91 | Professional | 52 · Reduced service | $93.33 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $346.74 | Professional | 54 · Surgery only | $177.83 | $177.83 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $69.18 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $46.77 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $95.50 | $120.23 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $346.74 | Professional | 54 · Surgery only | $177.83 | $177.83 | $346.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $70.79 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $46.77 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $46.77 |
Where Oregon sits
The same service costs 5.8 times more in Vermont than in Maine. 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
VT $4,478ME $766
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.