How much rates vary
Facilitymedian $100 · 10th to 90th $69 to $1,259Professionalmedian $93 · 10th to 90th $68 to $135
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 $63.10 Median $67.61 Typical High $67.61 | Professional | None | $63.10 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $676.08 | Facility | None | $398.11 | $501.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $134.90 | Professional | None | $64.57 | $79.43 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $112.20 | Professional | None | $77.62 | $89.13 | $112.20 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $154.88 Typical High $7,943.28 | Facility | None | $83.18 | $154.88 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $112.20 | Professional | None | $67.61 | $74.13 | $112.20 |
Pacific Source Setting Facility Modifier None Typical Low $61.66 Median $95.50 Typical High $107.15 | Facility | None | $61.66 | $95.50 | $107.15 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $478.63 Typical High $707.95 | Facility | None | $114.82 | $478.63 | $707.95 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $144.54 | Professional | None | $70.79 | $93.33 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,737.80 | Facility | None | $1,148.15 | $1,548.82 | $1,737.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $128.82 | Professional | None | $93.33 | $100.00 | $128.82 |
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 $74.13 Median $95.50 Typical High $154.88 | Professional | None | $74.13 | $95.50 | $154.88 |
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 $31.62 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $31.62 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 54 · Surgery only | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.55 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.31 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 54 · Surgery only | $47.86 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.55 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $6.76 |
Where Oregon sits
The same service costs 4.2 times more in Alaska 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· 9th of 51
$93.33
AK $200FL $47.86
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.