How much rates vary
Facilitymedian $204 · 10th to 90th $126 to $741Professionalmedian $158 · 10th to 90th $81 to $295
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 $66.07 Median $107.15 Typical High $173.78 | Professional | None | $66.07 | $107.15 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $660.69 | Facility | None | $134.90 | $169.82 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $165.96 Typical High $309.03 | Professional | None | $89.13 | $165.96 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $275.42 | Professional | None | $104.71 | $158.49 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $194.98 Typical High $7,943.28 | Facility | None | $123.03 | $194.98 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $204.17 | Professional | None | $74.13 | $125.89 | $204.17 |
Pacific Source Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $223.87 | Facility | None | $125.89 | $199.53 | $223.87 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $707.95 | Facility | None | $125.89 | $173.78 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $158.49 Typical High $302.00 | Professional | None | $79.43 | $158.49 | $302.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,187.76 | Facility | None | $1,318.26 | $1,819.70 | $2,187.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $302.00 | Professional | None | $114.82 | $199.53 | $302.00 |
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 $95.50 Median $173.78 Typical High $316.23 | Professional | None | $95.50 | $173.78 | $316.23 |
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 $43.65 Median $43.65 Typical High $87.10 | Professional | 52 · Reduced service | $43.65 | $43.65 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $35.48 | Professional | 53 · Discontinued | $17.38 | $17.38 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $131.83 | Professional | 54 · Surgery only | $64.57 | $64.57 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $26.30 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $17.38 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $17.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $87.10 | Professional | 52 · Reduced service | $43.65 | $43.65 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $35.48 | Professional | 53 · Discontinued | $17.38 | $17.38 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $131.83 | Professional | 54 · Surgery only | $64.57 | $64.57 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $26.30 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $17.38 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $17.38 |
Where Oregon sits
The same service costs 3.9 times more in Wisconsin 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· 6th of 51
$174
WI $251KY $64.57
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.