How much rates vary
Facilitymedian $525 · 10th to 90th $257 to $692Professionalmedian $447 · 10th to 90th $263 to $741
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 $263.03 Median $263.03 Typical High $446.68 | Professional | None | $263.03 | $263.03 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $416.87 | Facility | None | $169.82 | $302.00 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $489.78 Typical High $776.25 | Professional | None | $281.84 | $489.78 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $912.01 | Professional | None | $354.81 | $512.86 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $7,943.28 | Facility | None | $363.08 | $489.78 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $660.69 | Professional | None | $263.03 | $436.52 | $660.69 |
Pacific Source Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $645.65 | Facility | None | $338.84 | $537.03 | $645.65 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $338.84 Typical High $758.58 | Facility | None | $251.19 | $338.84 | $758.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $776.25 | Professional | None | $79.43 | $446.68 | $776.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,047.13 | Facility | None | $691.83 | $933.25 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $660.69 | Professional | None | $363.08 | $588.84 | $660.69 |
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 $275.42 Median $457.09 Typical High $812.83 | Professional | None | $275.42 | $457.09 | $812.83 |
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 $128.82 Median $128.82 Typical High $223.87 | Professional | 52 · Reduced service | $128.82 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $89.13 | Professional | 53 · Discontinued | $52.48 | $52.48 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | 54 · Surgery only | $194.98 | $194.98 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $66.07 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $44.67 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $223.87 | Professional | 52 · Reduced service | $128.82 | $128.82 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $89.13 | Professional | 53 · Discontinued | $52.48 | $52.48 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | 54 · Surgery only | $194.98 | $194.98 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $66.07 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $44.67 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $44.67 |
Where Oregon sits
The same service costs 3.8 times more in Alaska than in Maryland. 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
$447
AK $759MD $200
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.