How much rates vary
Facilitymedian $148 · 10th to 90th $91 to $4,074Professionalmedian $120 · 10th to 90th $85 to $195
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 $69.18 Median $87.10 Typical High $120.23 | Professional | None | $69.18 | $87.10 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $660.69 | Facility | None | $79.43 | $100.00 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $199.53 | Professional | None | $89.13 | $112.20 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $186.21 | Professional | None | $102.33 | $147.91 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $177.83 Typical High $6,606.93 | Facility | None | $120.23 | $177.83 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $165.96 | Professional | None | $87.10 | $120.23 | $165.96 |
Pacific Source Setting Facility Modifier None Typical Low $91.20 Median $138.04 Typical High $162.18 | Facility | None | $91.20 | $138.04 | $162.18 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $123.03 Typical High $707.95 | Facility | None | $81.28 | $123.03 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $199.53 | Professional | None | $79.43 | $125.89 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $6,025.60 | Facility | None | $3,801.89 | $5,248.07 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $177.83 | Professional | None | $112.20 | $144.54 | $177.83 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $204.17 | Professional | None | $93.33 | $131.83 | $204.17 |
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 $39.81 Median $43.65 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $17.38 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $66.07 Typical High $91.20 | Professional | 54 · Surgery only | $60.26 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.18 Typical High $18.20 | Professional | 55 · Aftercare only | $12.02 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.71 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $8.71 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $43.65 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $23.99 | Professional | 53 · Discontinued | $17.38 | $17.38 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | 54 · Surgery only | $66.07 | $66.07 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $18.20 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $12.02 |
Where Oregon sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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
$123
AK $240NJ $56.23
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.