How much rates vary
Facilitymedian $12 · 10th to 90th $7 to $363Professionalmedian $8 · 10th to 90th $3 to $18
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 $19.05 Median $5,011.87 Typical High $7,943.28 | Facility | None | $19.05 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $6.31 Typical High $11.75 | Professional | None | $2.95 | $6.31 | $11.75 |
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 $2.95 Median $6.76 Typical High $18.20 | Professional | None | $2.95 | $6.76 | $18.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.24 Median $4.57 Typical High $15.85 | Professional | None | $3.24 | $4.57 | $15.85 |
Moda Health Setting Facility Modifier None Typical Low $4.27 Median $13.80 Typical High $6,606.93 | Facility | None | $4.27 | $13.80 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $2.95 Median $7.41 Typical High $16.98 | Professional | None | $2.95 | $7.41 | $16.98 |
Pacific Source Setting Facility Modifier None Typical Low $7.41 Median $11.48 Typical High $13.49 | Facility | None | $7.41 | $11.48 | $13.49 |
Providence Setting Facility Modifier None Typical Low $3.47 Median $13.18 Typical High $100.00 | Facility | None | $3.47 | $13.18 | $100.00 |
Providence Setting Professional Modifier None Typical Low $3.31 Median $10.23 Typical High $79.43 | Professional | None | $3.31 | $10.23 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $3.80 Median $8.13 Typical High $13.49 | Professional | None | $3.80 | $8.13 | $13.49 |
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 $3.39 Median $7.76 Typical High $18.20 | Professional | None | $3.39 | $7.76 | $18.20 |
12 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 $1.48 Median $2.34 Typical High $4.79 | Professional | 52 · Reduced service | $1.48 | $2.34 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.93 Typical High $1.91 | Professional | 53 · Discontinued | $0.59 | $0.93 | $1.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.19 Median $3.47 Typical High $7.08 | Professional | 54 · Surgery only | $2.19 | $3.47 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.71 Typical High $1.45 | Professional | 55 · Aftercare only | $0.44 | $0.71 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.47 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.30 | $0.47 | $0.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $2.00 Typical High $4.79 | Professional | 52 · Reduced service | $1.48 | $2.00 | $4.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.79 Typical High $1.91 | Professional | 53 · Discontinued | $0.59 | $0.79 | $1.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2.19 Median $2.95 Typical High $7.08 | Professional | 54 · Surgery only | $2.19 | $2.95 | $7.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.76 Typical High $1.45 | Professional | 55 · Aftercare only | $0.44 | $0.76 | $1.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.50 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.30 | $0.50 | $0.95 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $5.50 Median $7.76 Typical High $21.38 | Professional | 59 · Distinct service | $5.50 | $7.76 | $21.38 |
Moda Health Setting Professional Modifier XS · Separate structure Typical Low $7.08 Median $16.60 Typical High $20.42 | Professional | XS · Separate structure | $7.08 | $16.60 | $20.42 |
Where Oregon sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$9.55
AK $12.88NE $4.37
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.