How much rates vary
Facilitymedian $166 · 10th to 90th $95 to $251Professionalmedian $132 · 10th to 90th $72 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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $144.54 | Professional | None | $56.23 | $95.50 | $144.54 |
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 $83.18 Median $141.25 Typical High $239.88 | Professional | None | $83.18 | $141.25 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $208.93 | Professional | None | $87.10 | $131.83 | $208.93 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $165.96 Typical High $7,943.28 | Facility | None | $102.33 | $165.96 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $199.53 | Professional | None | $63.10 | $117.49 | $199.53 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $158.49 Typical High $177.83 | Facility | None | $95.50 | $158.49 | $177.83 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $165.96 Typical High $302.00 | Facility | None | $100.00 | $165.96 | $302.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $234.42 | Professional | None | $79.43 | $134.90 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $257.04 | Professional | None | $100.00 | $165.96 | $257.04 |
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 $95.50 Median $151.36 Typical High $251.19 | Professional | None | $95.50 | $151.36 | $251.19 |
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 $36.31 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $36.31 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $18.20 Typical High $23.44 | Professional | 53 · Discontinued | $14.45 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $67.61 Typical High $87.10 | Professional | 54 · Surgery only | $53.70 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.49 Typical High $17.38 | Professional | 55 · Aftercare only | $10.72 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.24 | $9.12 | $11.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $36.31 Typical High $58.88 | Professional | 52 · Reduced service | $36.31 | $36.31 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $23.44 | Professional | 53 · Discontinued | $14.45 | $14.45 | $23.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $87.10 | Professional | 54 · Surgery only | $53.70 | $53.70 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $17.38 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $11.75 |
Where Oregon sits
The same service costs 3.7 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· 5th of 51
$148
WI $282FL $75.86
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.