How much rates vary
Facilitymedian $479 · 10th to 90th $275 to $871Professionalmedian $288 · 10th to 90th $117 to $708
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 $117.49 Median $275.42 Typical High $398.11 | Professional | None | $117.49 | $275.42 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,000.00 Typical High $2,137.96 | Facility | None | $691.83 | $1,000.00 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $707.95 | Professional | None | $138.04 | $281.84 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $588.84 | Professional | None | $147.91 | $218.78 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $660.69 Typical High $7,943.28 | Facility | None | $165.96 | $660.69 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $398.11 Typical High $741.31 | Professional | None | $117.49 | $398.11 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $549.54 | Facility | None | $331.13 | $478.63 | $549.54 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $562.34 Typical High $1,047.13 | Facility | None | $128.82 | $562.34 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $257.04 Typical High $707.95 | Professional | None | $79.43 | $257.04 | $707.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $741.31 | Professional | None | $165.96 | $302.00 | $741.31 |
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 $158.49 Median $380.19 Typical High $812.83 | Professional | None | $158.49 | $380.19 | $812.83 |
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 $58.88 Median $66.07 Typical High $199.53 | Professional | 52 · Reduced service | $58.88 | $66.07 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.30 Typical High $81.28 | Professional | 53 · Discontinued | $23.44 | $26.30 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $302.00 | Professional | 54 · Surgery only | $87.10 | $100.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $60.26 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $199.53 | Professional | 52 · Reduced service | $58.88 | $58.88 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $81.28 | Professional | 53 · Discontinued | $23.44 | $23.44 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $302.00 | Professional | 54 · Surgery only | $87.10 | $87.10 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $60.26 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $39.81 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $39.81 |
Where Oregon sits
The same service costs 3.6 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· 3rd of 51
$427
WI $537NE $148
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.