How much rates vary
Facilitymedian $52 · 10th to 90th $31 to $182Professionalmedian $30 · 10th to 90th $12 to $83
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 Professional Modifier None Typical Low $8.71 Median $22.39 Typical High $41.69 | Professional | None | $8.71 | $22.39 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $758.58 Typical High $2,511.89 | Facility | None | $660.69 | $758.58 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $33.11 Typical High $89.13 | Professional | None | $14.45 | $33.11 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.49 Median $23.44 Typical High $79.43 | Professional | None | $15.49 | $23.44 | $79.43 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $58.88 Typical High $1,778.28 | Facility | None | $17.38 | $58.88 | $1,778.28 |
Moda Health Setting Professional Modifier None Typical Low $10.00 Median $29.51 Typical High $75.86 | Professional | None | $10.00 | $29.51 | $75.86 |
Pacific Source Setting Facility Modifier None Typical Low $31.62 Median $51.29 Typical High $61.66 | Facility | None | $31.62 | $51.29 | $61.66 |
Providence Setting Facility Modifier None Typical Low $16.98 Median $52.48 Typical High $77.62 | Facility | None | $16.98 | $52.48 | $77.62 |
Providence Setting Professional Modifier None Typical Low $14.79 Median $46.77 Typical High $85.11 | Professional | None | $14.79 | $46.77 | $85.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.38 Median $30.90 Typical High $93.33 | Professional | None | $17.38 | $30.90 | $93.33 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $16.22 Median $33.88 Typical High $89.13 | Professional | None | $16.22 | $33.88 | $89.13 |
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 $6.03 Median $7.24 Typical High $20.89 | Professional | 52 · Reduced service | $6.03 | $7.24 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.88 Typical High $8.32 | Professional | 53 · Discontinued | $2.45 | $2.88 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $10.72 Typical High $30.90 | Professional | 54 · Surgery only | $9.12 | $10.72 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.14 Typical High $6.17 | Professional | 55 · Aftercare only | $1.82 | $2.14 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.45 Typical High $4.17 | Professional | 56 · Pre-op care only | $1.23 | $1.45 | $4.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $6.03 Typical High $20.89 | Professional | 52 · Reduced service | $6.03 | $6.03 | $20.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $8.32 | Professional | 53 · Discontinued | $2.45 | $2.45 | $8.32 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $9.12 Typical High $30.90 | Professional | 54 · Surgery only | $9.12 | $9.12 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $6.17 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $6.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $4.17 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $4.17 |
Where Oregon sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 4th of 51
$48.98
WI $67.61NE $16.22
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.