How much rates vary
Facilitymedian $191 · 10th to 90th $105 to $1,549Professionalmedian $95 · 10th to 90th $44 to $269
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 $29.51 Median $91.20 Typical High $162.18 | Professional | None | $29.51 | $91.20 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $173.78 Typical High $245.47 | Facility | None | $100.00 | $173.78 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $102.33 Typical High $288.40 | Professional | None | $44.67 | $102.33 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $251.19 | Professional | None | $56.23 | $87.10 | $251.19 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $263.03 Typical High $6,606.93 | Facility | None | $63.10 | $263.03 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $34.67 Median $97.72 Typical High $194.98 | Professional | None | $34.67 | $97.72 | $194.98 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $204.17 | Facility | None | $109.65 | $190.55 | $204.17 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $177.83 Typical High $263.03 | Facility | None | $69.18 | $177.83 | $263.03 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $275.42 | Professional | None | $51.29 | $87.10 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,041.74 | Facility | None | $1,318.26 | $1,778.28 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $56.23 Median $158.49 Typical High $269.15 | Professional | None | $56.23 | $158.49 | $269.15 |
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 $50.12 Median $120.23 Typical High $288.40 | Professional | None | $50.12 | $120.23 | $288.40 |
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 $21.88 Median $21.88 Typical High $81.28 | Professional | 52 · Reduced service | $21.88 | $21.88 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $33.11 | Professional | 53 · Discontinued | $8.71 | $8.71 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $123.03 | Professional | 54 · Surgery only | $33.11 | $33.11 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $24.55 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $16.22 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $16.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $81.28 | Professional | 52 · Reduced service | $21.88 | $21.88 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $33.11 | Professional | 53 · Discontinued | $8.71 | $8.71 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $123.03 | Professional | 54 · Surgery only | $33.11 | $33.11 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $24.55 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $16.22 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $16.22 |
Where Oregon sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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· 4th of 51
$162
WI $209HI $38.90
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.