How much rates vary
Facilitymedian $87 · 10th to 90th $51 to $204Professionalmedian $72 · 10th to 90th $38 to $135
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 $25.12 Median $44.67 Typical High $83.18 | Professional | None | $25.12 | $44.67 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $75.86 Typical High $102.33 | Facility | None | $61.66 | $75.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $77.62 Typical High $158.49 | Professional | None | $38.02 | $77.62 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $144.54 | Professional | None | $45.71 | $60.26 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $117.49 Typical High $6,606.93 | Facility | None | $54.95 | $117.49 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $53.70 Typical High $104.71 | Professional | None | $28.84 | $53.70 | $104.71 |
Pacific Source Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $114.82 | Facility | None | $50.12 | $87.10 | $114.82 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $77.62 Typical High $131.83 | Facility | None | $51.29 | $77.62 | $131.83 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $147.91 | Professional | None | $42.66 | $79.43 | $147.91 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $2,511.89 | Facility | None | $1,479.11 | $2,137.96 | $2,511.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $120.23 | Professional | None | $52.48 | $87.10 | $120.23 |
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 $44.67 Median $81.28 Typical High $158.49 | Professional | None | $44.67 | $81.28 | $158.49 |
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 $19.05 Median $19.05 Typical High $41.69 | Professional | 52 · Reduced service | $19.05 | $19.05 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $16.60 | Professional | 53 · Discontinued | $7.76 | $7.76 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $61.66 | Professional | 54 · Surgery only | $28.84 | $28.84 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $12.30 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $8.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $19.05 Typical High $41.69 | Professional | 52 · Reduced service | $19.05 | $19.05 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $16.60 | Professional | 53 · Discontinued | $7.76 | $7.76 | $16.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $61.66 | Professional | 54 · Surgery only | $28.84 | $28.84 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $12.30 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $8.32 |
Where Oregon sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 5th of 51
$79.43
AK $138NJ $41.69
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.