How much rates vary
Facilitymedian $162 · 10th to 90th $105 to $661Professionalmedian $158 · 10th to 90th $87 to $282
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 $75.86 Median $120.23 Typical High $426.58 | Professional | None | $75.86 | $120.23 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $109.65 Typical High $831.76 | Facility | None | $89.13 | $109.65 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $245.47 | Professional | None | $104.71 | $141.25 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $4,786.30 Typical High $7,943.28 | Facility | None | $85.11 | $4,786.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $398.11 | Professional | None | $75.86 | $120.23 | $398.11 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $162.18 Typical High $199.53 | Facility | None | $112.20 | $162.18 | $199.53 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $831.76 | Facility | None | $83.18 | $109.65 | $831.76 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $251.19 | Professional | None | $125.89 | $190.55 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $794.33 | Facility | None | $524.81 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $208.93 | Professional | None | $107.15 | $162.18 | $208.93 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $281.84 | Professional | None | $100.00 | $173.78 | $281.84 |
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 $38.02 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $38.02 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $15.49 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $57.54 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $11.48 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.59 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $38.02 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $15.49 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $57.54 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $11.48 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.59 | $12.02 | $12.02 |
Where Oregon sits
The same service costs 3.4 times more in Alaska than in Virginia. 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.
Oregon· 3rd of 51
$162
AK $263VA $77.62
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.