How much rates vary
Facilitymedian $224 · 10th to 90th $135 to $525Professionalmedian $162 · 10th to 90th $79 to $295
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 $66.07 Median $117.49 Typical High $194.98 | Professional | None | $66.07 | $117.49 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $208.93 | Facility | None | $95.50 | $151.36 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $331.13 | Professional | None | $100.00 | $181.97 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $295.12 | Professional | None | $107.15 | $138.04 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $7,943.28 | Facility | None | $151.36 | $213.80 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $295.12 | Professional | None | $77.62 | $138.04 | $295.12 |
Pacific Source Setting Facility Modifier None Typical Low $141.25 Median $239.88 Typical High $245.47 | Facility | None | $141.25 | $239.88 | $245.47 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $316.23 | Facility | None | $100.00 | $158.49 | $316.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $309.03 | Professional | None | $79.43 | $173.78 | $309.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $977.24 | Facility | None | $602.56 | $812.83 | $977.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $245.47 | Professional | None | $131.83 | $223.87 | $245.47 |
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 $107.15 Median $186.21 Typical High $331.13 | Professional | None | $107.15 | $186.21 | $331.13 |
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 $52.48 Median $52.48 Typical High $97.72 | Professional | 52 · Reduced service | $52.48 | $52.48 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $38.90 | Professional | 53 · Discontinued | $20.89 | $20.89 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $147.91 | Professional | 54 · Surgery only | $79.43 | $79.43 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $29.51 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $19.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $97.72 | Professional | 52 · Reduced service | $52.48 | $52.48 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $38.90 | Professional | 53 · Discontinued | $20.89 | $20.89 | $38.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $147.91 | Professional | 54 · Surgery only | $79.43 | $79.43 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $29.51 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $19.50 |
Where Oregon sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$186
AK $316MD $95.50
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.