How much rates vary
Facilitymedian $151 · 10th to 90th $110 to $7,943Professionalmedian $148 · 10th to 90th $79 to $229
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | None | $109.65 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $218.78 | Professional | None | $109.65 | $141.25 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $181.97 | Professional | None | $131.83 | $151.36 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $257.04 Typical High $7,943.28 | Facility | None | $165.96 | $257.04 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $204.17 | Professional | None | $114.82 | $123.03 | $204.17 |
Pacific Source Setting Facility Modifier None Typical Low $93.33 Median $151.36 Typical High $169.82 | Facility | None | $93.33 | $151.36 | $169.82 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $251,188.64 Typical High $251,188.64 | Facility | None | $177.83 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $229.09 | Professional | None | $79.43 | $147.91 | $229.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $229.09 | Professional | None | $147.91 | $154.88 | $229.09 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $269.15 | Professional | None | $117.49 | $186.21 | $269.15 |
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 $54.95 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $54.95 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $21.88 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.91 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 54 · Surgery only | $87.10 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Where Oregon sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 15th of 51
$151
TN $513NY $79.43
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.