How much rates vary
Facilitymedian $224 · 10th to 90th $105 to $389Professionalmedian $126 · 10th to 90th $68 to $302
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 $46.77 Median $83.18 Typical High $181.97 | Professional | None | $46.77 | $83.18 | $181.97 |
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 $69.18 Median $144.54 Typical High $331.13 | Professional | None | $69.18 | $144.54 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $288.40 | Professional | None | $75.86 | $109.65 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $181.97 Typical High $7,943.28 | Facility | None | $89.13 | $181.97 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $114.82 Typical High $346.74 | Professional | None | $57.54 | $114.82 | $346.74 |
Pacific Source Setting Facility Modifier None Typical Low $107.15 Median $223.87 Typical High $245.47 | Facility | None | $107.15 | $223.87 | $245.47 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $144.54 Typical High $316.23 | Facility | None | $61.66 | $144.54 | $316.23 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $309.03 | Professional | None | $70.79 | $125.89 | $309.03 |
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 $93.33 Median $162.18 Typical High $245.47 | Professional | None | $93.33 | $162.18 | $245.47 |
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 $77.62 Median $165.96 Typical High $331.13 | Professional | None | $77.62 | $165.96 | $331.13 |
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 $33.88 Median $33.88 Typical High $91.20 | Professional | 52 · Reduced service | $33.88 | $33.88 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $36.31 | Professional | 53 · Discontinued | $13.80 | $13.80 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $134.90 | Professional | 54 · Surgery only | $51.29 | $51.29 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $27.54 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $18.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $91.20 | Professional | 52 · Reduced service | $33.88 | $33.88 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $36.31 | Professional | 53 · Discontinued | $13.80 | $13.80 | $36.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $134.90 | Professional | 54 · Surgery only | $51.29 | $51.29 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $27.54 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $18.20 |
Where Oregon sits
The same service costs 3.4 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· 4th of 51
$170
AK $251NJ $74.13
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.