How much rates vary
Facilitymedian $324 · 10th to 90th $91 to $5,012Professionalmedian $120 · 10th to 90th $54 to $457
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 $37.15 Median $138.04 Typical High $295.12 | Professional | None | $37.15 | $138.04 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $162.18 Typical High $489.78 | Professional | None | $52.48 | $162.18 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $457.09 | Professional | None | $66.07 | $93.33 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $1,778.28 Typical High $6,606.93 | Facility | None | $85.11 | $1,778.28 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $138.04 Typical High $363.08 | Professional | None | $42.66 | $138.04 | $363.08 |
Pacific Source Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $338.84 | Facility | None | $173.78 | $288.40 | $338.84 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $302.00 Typical High $426.58 | Facility | None | $74.13 | $302.00 | $426.58 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $489.78 | Professional | None | $60.26 | $107.15 | $489.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $69.18 Median $218.78 Typical High $446.68 | Professional | None | $69.18 | $218.78 | $446.68 |
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 $47.86 Median $144.54 Typical High $478.63 | Professional | None | $47.86 | $144.54 | $478.63 |
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 $22.39 Median $56.23 Typical High $147.91 | Professional | 52 · Reduced service | $22.39 | $56.23 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $22.39 Typical High $58.88 | Professional | 53 · Discontinued | $8.91 | $22.39 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $83.18 Typical High $223.87 | Professional | 54 · Surgery only | $33.88 | $83.18 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $16.60 Typical High $44.67 | Professional | 55 · Aftercare only | $6.76 | $16.60 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $11.22 Typical High $29.51 | Professional | 56 · Pre-op care only | $4.47 | $11.22 | $29.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $37.15 Typical High $147.91 | Professional | 52 · Reduced service | $24.55 | $37.15 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $15.14 Typical High $58.88 | Professional | 53 · Discontinued | $9.77 | $15.14 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $56.23 Typical High $223.87 | Professional | 54 · Surgery only | $36.31 | $56.23 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $11.22 Typical High $44.67 | Professional | 55 · Aftercare only | $7.24 | $11.22 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.59 Typical High $29.51 | Professional | 56 · Pre-op care only | $4.90 | $7.59 | $29.51 |
Where Oregon sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 15th of 51
$174
WI $251MI $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.