How much rates vary
Facilitymedian $115 · 10th to 90th $71 to $1,514Professionalmedian $100 · 10th to 90th $59 to $162
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 $93.33 Median $3,235.94 Typical High $7,943.28 | Facility | None | $93.33 | $3,235.94 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $69.18 Typical High $89.13 | Professional | None | $43.65 | $69.18 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $2,137.96 | Facility | None | $660.69 | $1,000.00 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $162.18 | Professional | None | $70.79 | $100.00 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $144.54 | Professional | None | $81.28 | $109.65 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $389.05 Typical High $5,011.87 | Facility | None | $93.33 | $389.05 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $158.49 | Professional | None | $47.86 | $72.44 | $158.49 |
Pacific Source Setting Facility Modifier None Typical Low $69.18 Median $112.20 Typical High $120.23 | Facility | None | $69.18 | $112.20 | $120.23 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $125.89 Typical High $1,047.13 | Facility | None | $67.61 | $125.89 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $162.18 | Professional | None | $70.79 | $114.82 | $162.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $162.18 | Professional | None | $93.33 | $120.23 | $162.18 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $177.83 | Professional | None | $77.62 | $117.49 | $177.83 |
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 $32.36 Median $34.67 Typical High $42.66 | Professional | 52 · Reduced service | $32.36 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.80 Typical High $16.98 | Professional | 53 · Discontinued | $12.88 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $48.98 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $9.77 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.92 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.46 | $6.92 | $8.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $42.66 | Professional | 52 · Reduced service | $34.67 | $34.67 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $16.98 | Professional | 53 · Discontinued | $13.80 | $13.80 | $16.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | 54 · Surgery only | $52.48 | $52.48 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $8.51 |
Where Oregon sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 7th of 51
$107
AK $240KY $50.12
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.