How much rates vary
Facilitymedian $138 · 10th to 90th $72 to $380Professionalmedian $79 · 10th to 90th $40 to $195
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 $128.82 Median $5,011.87 Typical High $7,943.28 | Facility | None | $128.82 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $60.26 Typical High $128.82 | Professional | None | $32.36 | $60.26 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $128.82 Typical High $181.97 | Facility | None | $95.50 | $128.82 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $89.13 Typical High $245.47 | Professional | None | $39.81 | $89.13 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $218.78 | Professional | None | $47.86 | $67.61 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $158.49 Typical High $6,606.93 | Facility | None | $56.23 | $158.49 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $67.61 Typical High $162.18 | Professional | None | $33.11 | $67.61 | $162.18 |
Pacific Source Setting Facility Modifier None Typical Low $70.79 Median $123.03 Typical High $173.78 | Facility | None | $70.79 | $123.03 | $173.78 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $128.82 Typical High $190.55 | Facility | None | $64.57 | $128.82 | $190.55 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $223.87 | Professional | None | $45.71 | $79.43 | $223.87 |
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 $53.70 Median $91.20 Typical High $181.97 | Professional | None | $53.70 | $91.20 | $181.97 |
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 $46.77 Median $97.72 Typical High $239.88 | Professional | None | $46.77 | $97.72 | $239.88 |
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 $19.95 Median $19.95 Typical High $63.10 | Professional | 52 · Reduced service | $19.95 | $19.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $25.70 | Professional | 53 · Discontinued | $7.94 | $7.94 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $30.20 Typical High $95.50 | Professional | 54 · Surgery only | $30.20 | $30.20 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $19.05 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $12.88 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $12.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $19.95 Typical High $63.10 | Professional | 52 · Reduced service | $19.95 | $19.95 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $25.70 | Professional | 53 · Discontinued | $7.94 | $7.94 | $25.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $30.20 Typical High $95.50 | Professional | 54 · Surgery only | $30.20 | $30.20 | $95.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $19.05 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $12.88 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $12.88 |
Where Oregon sits
The same service costs 3.5 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· 6th of 51
$115
AK $151KY $43.65
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.