How much rates vary
Facilitymedian $65 · 10th to 90th $41 to $200Professionalmedian $50 · 10th to 90th $25 to $85
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 $23.99 Median $28.18 Typical High $52.48 | Professional | None | $23.99 | $28.18 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $660.69 Typical High $2,511.89 | Facility | None | $64.57 | $660.69 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $44.67 Typical High $83.18 | Professional | None | $24.55 | $44.67 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $75.86 | Professional | None | $27.54 | $35.48 | $75.86 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $7,943.28 | Facility | None | $34.67 | $74.13 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $23.99 Median $51.29 Typical High $81.28 | Professional | None | $23.99 | $51.29 | $81.28 |
Pacific Source Setting Facility Modifier None Typical Low $45.71 Median $58.88 Typical High $93.33 | Facility | None | $45.71 | $58.88 | $93.33 |
Providence Setting Facility Modifier None Typical Low $22.91 Median $64.57 Typical High $562.34 | Facility | None | $22.91 | $64.57 | $562.34 |
Providence Setting Professional Modifier None Typical Low $27.54 Median $51.29 Typical High $89.13 | Professional | None | $27.54 | $51.29 | $89.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $60.26 | Professional | None | $30.90 | $54.95 | $60.26 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $26.92 Median $56.23 Typical High $97.72 | Professional | None | $26.92 | $56.23 | $97.72 |
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 $12.02 Median $12.02 Typical High $26.30 | Professional | 52 · Reduced service | $12.02 | $12.02 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $10.47 | Professional | 53 · Discontinued | $4.79 | $4.79 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.20 Typical High $38.90 | Professional | 54 · Surgery only | $18.20 | $18.20 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $7.76 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $5.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.02 Typical High $26.30 | Professional | 52 · Reduced service | $12.02 | $12.02 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $10.47 | Professional | 53 · Discontinued | $4.79 | $4.79 | $10.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.20 Typical High $38.90 | Professional | 54 · Surgery only | $18.20 | $18.20 | $38.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $7.76 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $5.25 |
Where Oregon sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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
$54.95
AK $85.11HI $21.88
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.