How much rates vary
Facilitymedian $145 · 10th to 90th $89 to $427Professionalmedian $115 · 10th to 90th $72 to $200
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 $57.54 Median $72.44 Typical High $112.20 | Professional | None | $57.54 | $72.44 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $151.36 | Facility | None | $85.11 | $109.65 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $218.78 | Professional | None | $74.13 | $123.03 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $213.80 | Professional | None | $83.18 | $109.65 | $213.80 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $7,943.28 | Facility | None | $79.43 | $131.83 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $169.82 | Professional | None | $72.44 | $112.20 | $169.82 |
Pacific Source Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $162.18 | Facility | None | $87.10 | $141.25 | $162.18 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $117.49 Typical High $190.55 | Facility | None | $69.18 | $117.49 | $190.55 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $199.53 | Professional | None | $74.13 | $120.23 | $199.53 |
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 $97.72 Median $151.36 Typical High $165.96 | Professional | None | $97.72 | $151.36 | $165.96 |
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 $131.83 Typical High $223.87 | Professional | None | $77.62 | $131.83 | $223.87 |
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 $28.84 Median $36.31 Typical High $56.23 | Professional | 52 · Reduced service | $28.84 | $36.31 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.45 Typical High $22.39 | Professional | 53 · Discontinued | $11.48 | $14.45 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $53.70 Typical High $85.11 | Professional | 54 · Surgery only | $42.66 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $16.98 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $11.22 | Professional | 56 · Pre-op care only | $5.75 | $7.24 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $36.31 Typical High $56.23 | Professional | 52 · Reduced service | $28.84 | $36.31 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.45 Typical High $22.39 | Professional | 53 · Discontinued | $11.48 | $14.45 | $22.39 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $53.70 Typical High $85.11 | Professional | 54 · Surgery only | $42.66 | $53.70 | $85.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $16.98 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $11.22 | Professional | 56 · Pre-op care only | $5.75 | $7.24 | $11.22 |
Where Oregon sits
The same service costs 3.4 times more in Alaska than in New York. 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
$129
AK $209NY $61.66
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.