How much rates vary
Facilitymedian $295 · 10th to 90th $151 to $5,012Professionalmedian $174 · 10th to 90th $87 to $407
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 $79.43 Median $138.04 Typical High $251.19 | Professional | None | $79.43 | $138.04 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $426.58 | Professional | None | $87.10 | $181.97 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $380.19 | Professional | None | $107.15 | $151.36 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $331.13 Typical High $7,943.28 | Facility | None | $131.83 | $331.13 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $181.97 Typical High $331.13 | Professional | None | $93.33 | $181.97 | $331.13 |
Pacific Source Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $323.59 | Facility | None | $173.78 | $281.84 | $323.59 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $251.19 Typical High $363.08 | Facility | None | $120.23 | $251.19 | $363.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $416.87 | Professional | None | $79.43 | $169.82 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $380.19 | Professional | None | $114.82 | $199.53 | $380.19 |
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 $79.43 Median $169.82 Typical High $407.38 | Professional | None | $79.43 | $169.82 | $407.38 |
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 $37.15 Median $69.18 Typical High $125.89 | Professional | 52 · Reduced service | $37.15 | $69.18 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $27.54 Typical High $50.12 | Professional | 53 · Discontinued | $15.14 | $27.54 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $102.33 Typical High $190.55 | Professional | 54 · Surgery only | $56.23 | $102.33 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $20.89 Typical High $38.02 | Professional | 55 · Aftercare only | $11.22 | $20.89 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $13.80 Typical High $25.12 | Professional | 56 · Pre-op care only | $7.59 | $13.80 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $63.10 Typical High $125.89 | Professional | 52 · Reduced service | $39.81 | $63.10 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $25.12 Typical High $50.12 | Professional | 53 · Discontinued | $15.85 | $25.12 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $93.33 Typical High $190.55 | Professional | 54 · Surgery only | $60.26 | $93.33 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $19.05 Typical High $38.02 | Professional | 55 · Aftercare only | $12.02 | $19.05 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.59 Typical High $25.12 | Professional | 56 · Pre-op care only | $7.94 | $12.59 | $25.12 |
Where Oregon sits
The same service costs 3.7 times more in Wisconsin 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· 10th of 51
$191
WI $302MD $81.28
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.