How much rates vary
Facilitymedian $28 · 10th to 90th $17 to $234Professionalmedian $20 · 10th to 90th $10 to $40
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 $12.88 Median $33.88 Typical High $7,943.28 | Facility | None | $12.88 | $33.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $15.85 Typical High $25.12 | Professional | None | $6.92 | $15.85 | $25.12 |
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 $10.47 Median $20.89 Typical High $38.02 | Professional | None | $10.47 | $20.89 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $34.67 | Professional | None | $12.59 | $16.60 | $34.67 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $33.88 Typical High $165.96 | Facility | None | $15.14 | $33.88 | $165.96 |
Moda Health Setting Professional Modifier None Typical Low $7.94 Median $17.78 Typical High $29.51 | Professional | None | $7.94 | $17.78 | $29.51 |
Pacific Source Setting Facility Modifier None Typical Low $16.22 Median $26.92 Typical High $30.20 | Facility | None | $16.22 | $26.92 | $30.20 |
Providence Setting Facility Modifier None Typical Low $13.49 Median $30.90 Typical High $100.00 | Facility | None | $13.49 | $30.90 | $100.00 |
Providence Setting Professional Modifier None Typical Low $11.75 Median $22.39 Typical High $79.43 | Professional | None | $11.75 | $22.39 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $162.18 Median $213.80 Typical High $245.47 | Facility | None | $162.18 | $213.80 | $245.47 |
Regence BlueShield Setting Professional Modifier None Typical Low $14.13 Median $23.99 Typical High $28.84 | Professional | None | $14.13 | $23.99 | $28.84 |
United Setting Facility Modifier None Typical Low $151.36 Median $257.04 Typical High $4,897.79 | Facility | None | $151.36 | $257.04 | $4,897.79 |
United Setting Professional Modifier None Typical Low $11.75 Median $21.38 Typical High $38.90 | Professional | None | $11.75 | $21.38 | $38.90 |
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 $5.25 Median $5.25 Typical High $10.23 | Professional | 52 · Reduced service | $5.25 | $5.25 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $4.07 | Professional | 53 · Discontinued | $2.14 | $2.14 | $4.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $7.94 Typical High $15.14 | Professional | 54 · Surgery only | $7.94 | $7.94 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $3.02 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $2.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.25 Median $5.25 Typical High $10.23 | Professional | 52 · Reduced service | $5.25 | $5.25 | $10.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $4.07 | Professional | 53 · Discontinued | $2.14 | $2.14 | $4.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $7.94 Median $7.94 Typical High $15.14 | Professional | 54 · Surgery only | $7.94 | $7.94 | $15.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $3.02 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $3.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $2.04 |
Where Oregon sits
The same service costs 3.5 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· 6th of 51
$23.44
AK $38.90NJ $11.22
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.