How much rates vary
Facilitymedian $302 · 10th to 90th $182 to $5,012Professionalmedian $204 · 10th to 90th $100 to $372
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 $295.12 Median $5,623.41 Typical High $8,709.64 | Facility | None | $295.12 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $229.09 | Professional | None | $87.10 | $134.90 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $194.98 Typical High $691.83 | Facility | None | $154.88 | $194.98 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $426.58 | Professional | None | $134.90 | $234.42 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $389.05 | Professional | None | $158.49 | $208.93 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $1,698.24 Typical High $7,943.28 | Facility | None | $186.21 | $1,698.24 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $295.12 | Professional | None | $87.10 | $165.96 | $295.12 |
Pacific Source Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $316.23 | Facility | None | $181.97 | $295.12 | $316.23 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $691.83 | Facility | None | $154.88 | $218.78 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $229.09 Typical High $407.38 | Professional | None | $79.43 | $229.09 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $7,413.10 | Facility | None | $4,786.30 | $6,456.54 | $7,413.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $323.59 | Professional | None | $177.83 | $295.12 | $323.59 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $426.58 | Professional | None | $147.91 | $251.19 | $426.58 |
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 $63.10 Median $64.57 Typical High $114.82 | Professional | 52 · Reduced service | $63.10 | $64.57 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $45.71 | Professional | 53 · Discontinued | $25.12 | $25.70 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $97.72 Typical High $169.82 | Professional | 54 · Surgery only | $95.50 | $97.72 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $34.67 | Professional | 55 · Aftercare only | $19.05 | $19.50 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $64.57 Typical High $114.82 | Professional | 52 · Reduced service | $63.10 | $64.57 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $45.71 | Professional | 53 · Discontinued | $25.12 | $25.70 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $97.72 Typical High $169.82 | Professional | 54 · Surgery only | $95.50 | $97.72 | $169.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $34.67 | Professional | 55 · Aftercare only | $19.05 | $19.50 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $22.91 |
Where Oregon sits
The same service costs 3.2 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· 5th of 51
$234
AK $407NJ $129
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.