How much rates vary
Facilitymedian $87 · 10th to 90th $51 to $479Professionalmedian $66 · 10th to 90th $33 to $120
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 $40.74 Median $3,235.94 Typical High $6,606.93 | Facility | None | $40.74 | $3,235.94 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $57.54 Typical High $79.43 | Professional | None | $28.18 | $57.54 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $64.57 Typical High $123.03 | Professional | None | $35.48 | $64.57 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $109.65 | Professional | None | $41.69 | $63.10 | $109.65 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $128.82 Typical High $5,011.87 | Facility | None | $45.71 | $128.82 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $61.66 Typical High $117.49 | Professional | None | $32.36 | $61.66 | $117.49 |
Pacific Source Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $100.00 | Facility | None | $51.29 | $85.11 | $100.00 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $74.13 Typical High $147.91 | Facility | None | $44.67 | $74.13 | $147.91 |
Providence Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $123.03 | Professional | None | $40.74 | $74.13 | $123.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $512.86 | Facility | None | $323.59 | $446.68 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $120.23 | Professional | None | $48.98 | $81.28 | $120.23 |
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 $43.65 Median $74.13 Typical High $125.89 | Professional | None | $43.65 | $74.13 | $125.89 |
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 $16.22 Median $19.50 Typical High $30.90 | Professional | 52 · Reduced service | $16.22 | $19.50 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.76 Typical High $12.30 | Professional | 53 · Discontinued | $6.61 | $7.76 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $28.84 Typical High $45.71 | Professional | 54 · Surgery only | $24.55 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.75 Typical High $9.12 | Professional | 55 · Aftercare only | $4.90 | $5.75 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.89 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.31 | $3.89 | $6.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $30.90 | Professional | 52 · Reduced service | $16.22 | $16.22 | $30.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $12.30 | Professional | 53 · Discontinued | $6.61 | $6.61 | $12.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $24.55 Typical High $45.71 | Professional | 54 · Surgery only | $24.55 | $24.55 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $9.12 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $6.17 |
Where Oregon sits
The same service costs 3.4 times more in Wisconsin than in Utah. 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
$75.86
WI $132UT $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.