How much rates vary
Facilitymedian $54 · 10th to 90th $32 to $275Professionalmedian $41 · 10th to 90th $21 to $78
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 $25.70 Median $50.12 Typical High $64.57 | Facility | None | $25.70 | $50.12 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $30.20 Typical High $40.74 | Professional | None | $16.22 | $30.20 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $40.74 Typical High $77.62 | Professional | None | $23.44 | $40.74 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.70 Median $38.02 Typical High $69.18 | Professional | None | $25.70 | $38.02 | $69.18 |
Moda Health Setting Facility Modifier None Typical Low $20.89 Median $50.12 Typical High $234.42 | Facility | None | $20.89 | $50.12 | $234.42 |
Moda Health Setting Professional Modifier None Typical Low $20.89 Median $35.48 Typical High $67.61 | Professional | None | $20.89 | $35.48 | $67.61 |
Pacific Source Setting Facility Modifier None Typical Low $34.67 Median $53.70 Typical High $60.26 | Facility | None | $34.67 | $53.70 | $60.26 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $44.67 Typical High $83.18 | Facility | None | $20.42 | $44.67 | $83.18 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $45.71 Typical High $79.43 | Professional | None | $24.55 | $45.71 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $512.86 | Facility | None | $323.59 | $446.68 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.18 Median $43.65 Typical High $72.44 | Professional | None | $28.18 | $43.65 | $72.44 |
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 $26.30 Median $46.77 Typical High $79.43 | Professional | None | $26.30 | $46.77 | $79.43 |
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 $10.47 Median $11.48 Typical High $20.42 | Professional | 52 · Reduced service | $10.47 | $11.48 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.57 Typical High $8.13 | Professional | 53 · Discontinued | $4.17 | $4.57 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $16.98 Typical High $30.90 | Professional | 54 · Surgery only | $15.85 | $16.98 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.39 Typical High $6.17 | Professional | 55 · Aftercare only | $3.16 | $3.39 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.29 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.09 | $2.29 | $4.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $11.48 Typical High $20.42 | Professional | 52 · Reduced service | $10.47 | $11.48 | $20.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.57 Typical High $8.13 | Professional | 53 · Discontinued | $4.17 | $4.57 | $8.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $16.98 Typical High $30.90 | Professional | 54 · Surgery only | $15.85 | $16.98 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.39 Typical High $6.17 | Professional | 55 · Aftercare only | $3.16 | $3.39 | $6.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.29 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.09 | $2.29 | $4.07 |
Where Oregon sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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
$50.12
WI $87.10KY $25.12
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.