How much rates vary
Facilitymedian $151 · 10th to 90th $91 to $1,995Professionalmedian $132 · 10th to 90th $79 to $224
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 $64.57 Median $107.15 Typical High $107.15 | Professional | None | $64.57 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $776.25 Typical High $1,047.13 | Facility | None | $446.68 | $776.25 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $218.78 | Professional | None | $109.65 | $131.83 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $181.97 | Professional | None | $125.89 | $162.18 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $177.83 Typical High $7,943.28 | Facility | None | $107.15 | $177.83 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $154.88 | Professional | None | $61.66 | $107.15 | $154.88 |
Pacific Source Setting Facility Modifier None Typical Low $91.20 Median $144.54 Typical High $158.49 | Facility | None | $91.20 | $144.54 | $158.49 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $724.44 Typical High $1,000.00 | Facility | None | $112.20 | $724.44 | $1,000.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $234.42 | Professional | None | $79.43 | $114.82 | $234.42 |
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 $147.91 Median $158.49 Typical High $199.53 | Professional | None | $147.91 | $158.49 | $199.53 |
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 $102.33 Median $138.04 Typical High $257.04 | Professional | None | $102.33 | $138.04 | $257.04 |
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 $32.36 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $32.36 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $12.88 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $81.28 Typical High $81.28 | Professional | 54 · Surgery only | $47.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $9.55 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.46 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $30.20 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $12.02 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $81.28 Typical High $81.28 | Professional | 54 · Surgery only | $45.71 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $9.12 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.03 | $10.72 | $10.72 |
Where Oregon sits
The same service costs 5.5 times more in Arkansas 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· 8th of 51
$151
AR $331KY $60.26
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.