How much rates vary
Facilitymedian $87 · 10th to 90th $51 to $275Professionalmedian $62 · 10th to 90th $34 to $107
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 $51.29 Median $3,235.94 Typical High $7,943.28 | Facility | None | $51.29 | $3,235.94 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $75.86 | Professional | None | $21.88 | $37.15 | $75.86 |
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 $33.88 Median $64.57 Typical High $120.23 | Professional | None | $33.88 | $64.57 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $109.65 | Professional | None | $39.81 | $52.48 | $109.65 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $77.62 Typical High $5,011.87 | Facility | None | $33.88 | $77.62 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $25.12 Median $47.86 Typical High $89.13 | Professional | None | $25.12 | $47.86 | $89.13 |
Pacific Source Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $89.13 | Facility | None | $51.29 | $85.11 | $89.13 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $67.61 Typical High $120.23 | Facility | None | $42.66 | $67.61 | $120.23 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $112.20 | Professional | None | $38.02 | $70.79 | $112.20 |
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 $44.67 Median $74.13 Typical High $89.13 | Professional | None | $44.67 | $74.13 | $89.13 |
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 $38.90 Median $67.61 Typical High $123.03 | Professional | None | $38.90 | $67.61 | $123.03 |
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 $16.60 Median $16.60 Typical High $32.36 | Professional | 52 · Reduced service | $16.60 | $16.60 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $12.88 | Professional | 53 · Discontinued | $6.76 | $6.76 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $25.12 Typical High $47.86 | Professional | 54 · Surgery only | $25.12 | $25.12 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $9.55 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $6.46 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $16.60 Typical High $32.36 | Professional | 52 · Reduced service | $16.60 | $16.60 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $12.88 | Professional | 53 · Discontinued | $6.76 | $6.76 | $12.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $25.12 Typical High $47.86 | Professional | 54 · Surgery only | $25.12 | $25.12 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $9.55 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $6.46 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $9.77 Median $48.98 Typical High $128.82 | Professional | 59 · Distinct service | $9.77 | $48.98 | $128.82 |
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
$69.18
AK $120NJ $34.67
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.