How much rates vary
Facilitymedian $135 · 10th to 90th $51 to $589Professionalmedian $71 · 10th to 90th $31 to $186
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 $43.65 Median $3,235.94 Typical High $7,943.28 | Facility | None | $43.65 | $3,235.94 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $50.12 Typical High $123.03 | Professional | None | $24.55 | $50.12 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $70.79 Typical High $223.87 | Professional | None | $31.62 | $70.79 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $199.53 | Professional | None | $37.15 | $52.48 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $141.25 Typical High $6,606.93 | Facility | None | $43.65 | $141.25 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $60.26 Typical High $162.18 | Professional | None | $28.18 | $60.26 | $162.18 |
Pacific Source Setting Facility Modifier None Typical Low $47.86 Median $120.23 Typical High $162.18 | Facility | None | $47.86 | $120.23 | $162.18 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $100.00 Typical High $213.80 | Facility | None | $39.81 | $100.00 | $213.80 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $79.43 Typical High $208.93 | Professional | None | $35.48 | $79.43 | $208.93 |
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 $41.69 Median $74.13 Typical High $165.96 | Professional | None | $41.69 | $74.13 | $165.96 |
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 $36.31 Median $75.86 Typical High $218.78 | Professional | None | $36.31 | $75.86 | $218.78 |
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 $15.49 Median $15.49 Typical High $58.88 | Professional | 52 · Reduced service | $15.49 | $15.49 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $23.44 | Professional | 53 · Discontinued | $6.17 | $6.17 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $87.10 | Professional | 54 · Surgery only | $22.91 | $22.91 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $17.38 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $11.75 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $11.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $58.88 | Professional | 52 · Reduced service | $15.49 | $15.49 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $23.44 | Professional | 53 · Discontinued | $6.17 | $6.17 | $23.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $87.10 | Professional | 54 · Surgery only | $22.91 | $22.91 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $17.38 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.79 Typical High $11.75 | Professional | 56 · Pre-op care only | $3.09 | $4.79 | $11.75 |
Where Oregon sits
The same service costs 3.4 times more in Wisconsin 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· 5th of 51
$95.50
WI $123KY $36.31
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.