How much rates vary
Facilitymedian $166 · 10th to 90th $91 to $316Professionalmedian $148 · 10th to 90th $76 to $275
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 $61.66 Median $104.71 Typical High $169.82 | Professional | None | $61.66 | $104.71 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $173.78 | Facility | None | $95.50 | $123.03 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $281.84 | Professional | None | $77.62 | $147.91 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $245.47 | Professional | None | $87.10 | $131.83 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $295.12 Typical High $6,606.93 | Facility | None | $107.15 | $295.12 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $251.19 | Professional | None | $69.18 | $134.90 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $89.13 Median $165.96 Typical High $234.42 | Facility | None | $89.13 | $165.96 | $234.42 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $131.83 Typical High $295.12 | Facility | None | $93.33 | $131.83 | $295.12 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $281.84 | Professional | None | $79.43 | $147.91 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,621.81 | Facility | None | $954.99 | $1,348.96 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $275.42 | Professional | None | $104.71 | $177.83 | $275.42 |
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 $93.33 Median $165.96 Typical High $316.23 | Professional | None | $93.33 | $165.96 | $316.23 |
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 $38.02 Typical High $74.13 | Professional | 52 · Reduced service | $38.02 | $38.02 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $29.51 | Professional | 53 · Discontinued | $15.14 | $15.14 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $109.65 | Professional | 54 · Surgery only | $56.23 | $56.23 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $21.88 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $14.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $74.13 | Professional | 52 · Reduced service | $38.02 | $38.02 | $74.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $29.51 | Professional | 53 · Discontinued | $15.14 | $15.14 | $29.51 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $109.65 | Professional | 54 · Surgery only | $56.23 | $56.23 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $21.88 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $14.79 |
Where Oregon sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 9th of 51
$148
AK $257PA $93.33
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.