How much rates vary
Facilitymedian $182 · 10th to 90th $110 to $1,288Professionalmedian $135 · 10th to 90th $76 to $229
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $165.96 | Professional | None | $70.79 | $93.33 | $165.96 |
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 $77.62 Median $138.04 Typical High $251.19 | Professional | None | $77.62 | $138.04 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $234.42 | Professional | None | $91.20 | $117.49 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $218.78 Typical High $6,606.93 | Facility | None | $109.65 | $218.78 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $213.80 | Professional | None | $74.13 | $125.89 | $213.80 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $177.83 Typical High $190.55 | Facility | None | $109.65 | $177.83 | $190.55 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $169.82 Typical High $281.84 | Facility | None | $69.18 | $169.82 | $281.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $234.42 | Professional | None | $79.43 | $138.04 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,621.81 | Facility | None | $1,023.29 | $1,380.38 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $190.55 | Professional | None | $104.71 | $173.78 | $190.55 |
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 $87.10 Median $147.91 Typical High $257.04 | Professional | None | $87.10 | $147.91 | $257.04 |
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 $38.02 Median $38.02 Typical High $67.61 | Professional | 52 · Reduced service | $38.02 | $38.02 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $26.92 | Professional | 53 · Discontinued | $15.49 | $15.49 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $100.00 | Professional | 54 · Surgery only | $57.54 | $57.54 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $20.42 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $13.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $67.61 | Professional | 52 · Reduced service | $38.02 | $38.02 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $26.92 | Professional | 53 · Discontinued | $15.49 | $15.49 | $26.92 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $100.00 | Professional | 54 · Surgery only | $57.54 | $57.54 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $20.42 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $13.49 |
Where Oregon sits
The same service costs 3.2 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· 6th of 51
$151
AK $245NY $77.62
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.