How much rates vary
Facilitymedian $257 · 10th to 90th $158 to $5,129Professionalmedian $245 · 10th to 90th $129 to $372
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 $131.83 Median $186.21 Typical High $186.21 | Professional | None | $131.83 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $389.05 | Professional | None | $162.18 | $223.87 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $288.40 | Professional | None | $204.17 | $251.19 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $389.05 Typical High $7,943.28 | Facility | None | $263.03 | $389.05 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $338.84 | Professional | None | $181.97 | $199.53 | $338.84 |
Pacific Source Setting Facility Modifier None Typical Low $154.88 Median $251.19 Typical High $263.03 | Facility | None | $154.88 | $251.19 | $263.03 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $302.00 Typical High $389.05 | Facility | None | $158.49 | $302.00 | $389.05 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $371.54 | Professional | None | $79.43 | $245.47 | $371.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $354.81 | Professional | None | $245.47 | $257.04 | $354.81 |
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 $138.04 Median $263.03 Typical High $416.87 | Professional | None | $138.04 | $263.03 | $416.87 |
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 $64.57 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $64.57 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $26.30 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $97.72 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.18 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $64.57 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $25.70 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $97.72 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.88 | $18.62 | $18.62 |
Where Oregon sits
The same service costs 3.7 times more in Alaska than in New York. 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
$251
AK $447NY $120
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.