How much rates vary
Facilitymedian $89 · 10th to 90th $63 to $2,239Professionalmedian $79 · 10th to 90th $54 to $126
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 $38.90 Median $60.26 Typical High $77.62 | Professional | None | $38.90 | $60.26 | $77.62 |
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 $61.66 Median $72.44 Typical High $123.03 | Professional | None | $61.66 | $72.44 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $91.20 | Professional | None | $61.66 | $81.28 | $91.20 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $128.82 Typical High $7,943.28 | Facility | None | $79.43 | $128.82 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $128.82 | Professional | None | $40.74 | $64.57 | $128.82 |
Pacific Source Setting Facility Modifier None Typical Low $53.70 Median $85.11 Typical High $93.33 | Facility | None | $53.70 | $85.11 | $93.33 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $97.72 Typical High $812.83 | Facility | None | $54.95 | $97.72 | $812.83 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $125.89 | Professional | None | $63.10 | $83.18 | $125.89 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $2,511.89 | Facility | None | $1,479.11 | $2,137.96 | $2,511.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $112.20 | Professional | None | $81.28 | $89.13 | $112.20 |
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 $63.10 Median $85.11 Typical High $144.54 | Professional | None | $63.10 | $85.11 | $144.54 |
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 $19.50 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $19.50 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $7.76 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $47.86 Typical High $47.86 | Professional | 54 · Surgery only | $29.51 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $5.89 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.89 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $18.62 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $7.41 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $47.86 Typical High $47.86 | Professional | 54 · Surgery only | $27.54 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $5.50 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.72 | $6.31 | $6.31 |
Where Oregon sits
The same service costs 13.8 times more in Oklahoma 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· 15th of 51
$85.11
OK $575NY $41.69
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.