How much rates vary
Facilitymedian $62 · 10th to 90th $35 to $288Professionalmedian $39 · 10th to 90th $20 to $79
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 $33.11 Median $4,265.80 Typical High $7,943.28 | Facility | None | $33.11 | $4,265.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $26.30 Typical High $47.86 | Professional | None | $12.88 | $26.30 | $47.86 |
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 $20.42 Median $39.81 Typical High $89.13 | Professional | None | $20.42 | $39.81 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $79.43 | Professional | None | $23.44 | $32.36 | $79.43 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $74.13 Typical High $6,606.93 | Facility | None | $30.90 | $74.13 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $14.79 Median $31.62 Typical High $64.57 | Professional | None | $14.79 | $31.62 | $64.57 |
Pacific Source Setting Facility Modifier None Typical Low $36.31 Median $61.66 Typical High $66.07 | Facility | None | $36.31 | $61.66 | $66.07 |
Providence Setting Facility Modifier None Typical Low $25.70 Median $52.48 Typical High $100.00 | Facility | None | $25.70 | $52.48 | $100.00 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $48.98 Typical High $83.18 | Professional | None | $22.91 | $48.98 | $83.18 |
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 $26.92 Median $46.77 Typical High $66.07 | Professional | None | $26.92 | $46.77 | $66.07 |
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 $22.91 Median $45.71 Typical High $89.13 | Professional | None | $22.91 | $45.71 | $89.13 |
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 $10.00 Median $10.00 Typical High $23.99 | Professional | 52 · Reduced service | $10.00 | $10.00 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $9.55 | Professional | 53 · Discontinued | $4.07 | $4.07 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $15.14 Typical High $35.48 | Professional | 54 · Surgery only | $15.14 | $15.14 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $7.08 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $4.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $10.00 Typical High $23.99 | Professional | 52 · Reduced service | $10.00 | $10.00 | $23.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $9.55 | Professional | 53 · Discontinued | $4.07 | $4.07 | $9.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $15.14 Typical High $35.48 | Professional | 54 · Surgery only | $15.14 | $15.14 | $35.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $7.08 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $7.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $4.79 |
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· 4th of 51
$48.98
AK $83.18NJ $23.99
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.