How much rates vary
Facilitymedian $263 · 10th to 90th $117 to $5,495Professionalmedian $141 · 10th to 90th $65 to $316
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 $79.43 Median $5,128.61 Typical High $8,709.64 | Facility | None | $79.43 | $5,128.61 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $199.53 | Professional | None | $50.12 | $123.03 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $151.36 Typical High $323.59 | Professional | None | $66.07 | $151.36 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $288.40 | Professional | None | $85.11 | $120.23 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $371.54 Typical High $7,943.28 | Facility | None | $91.20 | $371.54 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $128.82 Typical High $269.15 | Professional | None | $54.95 | $128.82 | $269.15 |
Pacific Source Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $295.12 | Facility | None | $158.49 | $229.09 | $295.12 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $181.97 Typical High $371.54 | Facility | None | $91.20 | $181.97 | $371.54 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $323.59 | Professional | None | $75.86 | $138.04 | $323.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $295.12 | Professional | None | $89.13 | $154.88 | $295.12 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $4,897.79 Typical High $6,165.95 | Facility | None | $1,122.02 | $4,897.79 | $6,165.95 |
United Setting Professional Modifier None Typical Low $63.10 Median $141.25 Typical High $331.13 | Professional | None | $63.10 | $141.25 | $331.13 |
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 $30.90 Median $61.66 Typical High $91.20 | Professional | 52 · Reduced service | $30.90 | $61.66 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $24.55 Typical High $36.31 | Professional | 53 · Discontinued | $12.30 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $91.20 Typical High $138.04 | Professional | 54 · Surgery only | $46.77 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $18.20 Typical High $27.54 | Professional | 55 · Aftercare only | $9.33 | $18.20 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $12.30 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.17 | $12.30 | $18.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $43.65 Typical High $91.20 | Professional | 52 · Reduced service | $30.90 | $43.65 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $17.38 Typical High $36.31 | Professional | 53 · Discontinued | $12.30 | $17.38 | $36.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $66.07 Typical High $138.04 | Professional | 54 · Surgery only | $46.77 | $66.07 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.18 Typical High $27.54 | Professional | 55 · Aftercare only | $9.33 | $13.18 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.71 Typical High $18.20 | Professional | 56 · Pre-op care only | $6.17 | $8.71 | $18.20 |
Where Oregon sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 11th of 51
$151
WI $234FL $85.11
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.