How much rates vary
Facilitymedian $209 · 10th to 90th $112 to $302Professionalmedian $145 · 10th to 90th $79 to $324
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 $53.70 Median $93.33 Typical High $204.17 | Professional | None | $53.70 | $93.33 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $181.97 Typical High $257.04 | Facility | None | $102.33 | $181.97 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $371.54 | Professional | None | $91.20 | $173.78 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $323.59 | Professional | None | $95.50 | $131.83 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $204.17 Typical High $7,943.28 | Facility | None | $97.72 | $204.17 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $316.23 | Professional | None | $61.66 | $120.23 | $316.23 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $208.93 Typical High $269.15 | Facility | None | $109.65 | $208.93 | $269.15 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $181.97 Typical High $288.40 | Facility | None | $102.33 | $181.97 | $288.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $346.74 | Professional | None | $79.43 | $154.88 | $346.74 |
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 $117.49 Median $199.53 Typical High $275.42 | Professional | None | $117.49 | $199.53 | $275.42 |
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 $97.72 Median $190.55 Typical High $371.54 | Professional | None | $97.72 | $190.55 | $371.54 |
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 $43.65 Median $43.65 Typical High $102.33 | Professional | 52 · Reduced service | $43.65 | $43.65 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $40.74 | Professional | 53 · Discontinued | $17.38 | $17.38 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $66.07 Typical High $151.36 | Professional | 54 · Surgery only | $64.57 | $66.07 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $30.20 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $102.33 | Professional | 52 · Reduced service | $43.65 | $43.65 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $40.74 | Professional | 53 · Discontinued | $17.38 | $17.38 | $40.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $66.07 Typical High $151.36 | Professional | 54 · Surgery only | $64.57 | $66.07 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $30.20 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $20.42 |
Where Oregon sits
The same service costs 3.2 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
$178
AK $275KY $85.11
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.