How much rates vary
Facilitymedian $35 · 10th to 90th $22 to $182Professionalmedian $31 · 10th to 90th $19 to $54
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $19.95 Typical High $26.30 | Professional | None | $14.13 | $19.95 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $660.69 Typical High $2,511.89 | Facility | None | $64.57 | $660.69 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $50.12 | Professional | None | $22.39 | $29.51 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $44.67 | Professional | None | $23.99 | $30.90 | $44.67 |
Moda Health Setting Facility Modifier None Typical Low $25.70 Median $39.81 Typical High $7,943.28 | Facility | None | $25.70 | $39.81 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $15.14 Median $25.70 Typical High $45.71 | Professional | None | $15.14 | $25.70 | $45.71 |
Pacific Source Setting Facility Modifier None Typical Low $21.38 Median $33.88 Typical High $37.15 | Facility | None | $21.38 | $33.88 | $37.15 |
Providence Setting Facility Modifier None Typical Low $25.70 Median $39.81 Typical High $562.34 | Facility | None | $25.70 | $39.81 | $562.34 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $35.48 Typical High $79.43 | Professional | None | $23.99 | $35.48 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $45.71 | Professional | None | $30.90 | $34.67 | $45.71 |
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 $22.91 Median $32.36 Typical High $54.95 | Professional | None | $22.91 | $32.36 | $54.95 |
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 $7.59 Median $11.22 Typical High $12.88 | Professional | 52 · Reduced service | $7.59 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $4.57 Typical High $5.13 | Professional | 53 · Discontinued | $3.02 | $4.57 | $5.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $16.98 Typical High $19.05 | Professional | 54 · Surgery only | $11.22 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $3.39 Typical High $3.89 | Professional | 55 · Aftercare only | $2.24 | $3.39 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.29 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.51 | $2.29 | $2.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $11.22 Typical High $12.88 | Professional | 52 · Reduced service | $7.59 | $11.22 | $12.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $4.57 Typical High $5.13 | Professional | 53 · Discontinued | $3.02 | $4.57 | $5.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $11.22 Median $16.98 Typical High $19.05 | Professional | 54 · Surgery only | $11.22 | $16.98 | $19.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $3.39 Typical High $3.89 | Professional | 55 · Aftercare only | $2.24 | $3.39 | $3.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $2.29 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.51 | $2.29 | $2.57 |
Where Oregon sits
The same service costs 3.9 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· 7th of 51
$31.62
AK $64.57NJ $16.60
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.