How much rates vary
Facilitymedian $363 · 10th to 90th $214 to $1,230Professionalmedian $295 · 10th to 90th $162 to $525
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 $3,890.45 Median $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $302.00 | Professional | None | $138.04 | $186.21 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $263.03 Typical High $660.69 | Facility | None | $208.93 | $263.03 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $549.54 | Professional | None | $173.78 | $295.12 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $478.63 | Professional | None | $199.53 | $302.00 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $7,943.28 | Facility | None | $251.19 | $436.52 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $407.38 | Professional | None | $154.88 | $239.88 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $363.08 Typical High $398.11 | Facility | None | $218.78 | $363.08 | $398.11 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $288.40 Typical High $707.95 | Facility | None | $208.93 | $288.40 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $302.00 Typical High $537.03 | Professional | None | $79.43 | $302.00 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,698.24 | Facility | None | $1,122.02 | $1,412.54 | $1,698.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $537.03 | Professional | None | $229.09 | $380.19 | $537.03 |
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 $199.53 Median $323.59 Typical High $562.34 | Professional | None | $199.53 | $323.59 | $562.34 |
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 $87.10 Median $87.10 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $87.10 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $35.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $229.09 | Professional | 54 · Surgery only | $131.83 | $131.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $87.10 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $35.48 | $60.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $229.09 | Professional | 54 · Surgery only | $131.83 | $131.83 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $30.20 |
Where Oregon sits
The same service costs 3.0 times more in Wisconsin 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· 5th of 51
$316
WI $537MD $182
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.