How much rates vary
Facilitymedian $182 · 10th to 90th $69 to $457Professionalmedian $89 · 10th to 90th $47 to $245
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 $26.92 Median $60.26 Typical High $151.36 | Professional | None | $26.92 | $60.26 | $151.36 |
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 $48.98 Median $102.33 Typical High $275.42 | Professional | None | $48.98 | $102.33 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $239.88 | Professional | None | $52.48 | $74.13 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $51.29 Median $144.54 Typical High $7,943.28 | Facility | None | $51.29 | $144.54 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $89.13 Typical High $288.40 | Professional | None | $33.88 | $89.13 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $69.18 Median $173.78 Typical High $204.17 | Facility | None | $69.18 | $173.78 | $204.17 |
Providence Setting Facility Modifier None Typical Low $47.86 Median $100.00 Typical High $263.03 | Facility | None | $47.86 | $100.00 | $263.03 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $257.04 | Professional | None | $53.70 | $89.13 | $257.04 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $1,621.81 | Facility | None | $524.81 | $1,096.48 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $114.82 Typical High $204.17 | Professional | None | $64.57 | $114.82 | $204.17 |
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 $53.70 Median $117.49 Typical High $269.15 | Professional | None | $53.70 | $117.49 | $269.15 |
11 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 $23.44 Median $23.44 Typical High $75.86 | Professional | 52 · Reduced service | $23.44 | $23.44 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $30.20 | Professional | 53 · Discontinued | $9.33 | $9.33 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $112.20 | Professional | 54 · Surgery only | $35.48 | $35.48 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $22.39 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $15.14 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $23.44 Typical High $75.86 | Professional | 52 · Reduced service | $23.44 | $23.44 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $30.20 | Professional | 53 · Discontinued | $9.33 | $9.33 | $30.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $112.20 | Professional | 54 · Surgery only | $35.48 | $35.48 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $22.39 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $15.14 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $15.14 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $35.48 Median $69.18 Typical High $302.00 | Professional | 59 · Distinct service | $35.48 | $69.18 | $302.00 |
Where Oregon sits
The same service costs 3.3 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· 5th of 51
$123
AK $170KY $51.29
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.