How much rates vary
Facilitymedian $158 · 10th to 90th $76 to $741Professionalmedian $95 · 10th to 90th $51 to $219
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 $67.61 Median $3,235.94 Typical High $7,943.28 | Facility | None | $67.61 | $3,235.94 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $141.25 | Professional | None | $32.36 | $64.57 | $141.25 |
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 $54.95 Median $104.71 Typical High $239.88 | Professional | None | $54.95 | $104.71 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $223.87 | Professional | None | $67.61 | $89.13 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $190.55 Typical High $5,011.87 | Facility | None | $72.44 | $190.55 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $95.50 Typical High $234.42 | Professional | None | $38.90 | $95.50 | $234.42 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $151.36 Typical High $173.78 | Facility | None | $81.28 | $151.36 | $173.78 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $125.89 Typical High $562.34 | Facility | None | $54.95 | $125.89 | $562.34 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $218.78 | Professional | None | $60.26 | $97.72 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $794.33 | Facility | None | $524.81 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $173.78 | Professional | None | $72.44 | $123.03 | $173.78 |
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 $57.54 Median $117.49 Typical High $229.09 | Professional | None | $57.54 | $117.49 | $229.09 |
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 $25.70 Median $25.70 Typical High $64.57 | Professional | 52 · Reduced service | $25.70 | $25.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $26.30 | Professional | 53 · Discontinued | $10.23 | $10.23 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $97.72 | Professional | 54 · Surgery only | $38.02 | $38.02 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $19.50 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $12.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $25.70 Typical High $64.57 | Professional | 52 · Reduced service | $25.70 | $25.70 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $26.30 | Professional | 53 · Discontinued | $10.23 | $10.23 | $26.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $97.72 | Professional | 54 · Surgery only | $38.02 | $38.02 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $19.50 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.31 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.13 | $6.31 | $12.88 |
Where Oregon sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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
$126
AK $178KY $47.86
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.