How much rates vary
Facilitymedian $55 · 10th to 90th $35 to $3,236Professionalmedian $81 · 10th to 90th $28 to $148
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 $28.18 Median $28.18 Typical High $28.84 | Professional | None | $28.18 | $28.18 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $870.96 | Facility | None | $223.87 | $281.84 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $81.28 Typical High $131.83 | Professional | None | $51.29 | $81.28 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $141.25 | Professional | None | $100.00 | $114.82 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $5,011.87 Typical High $7,943.28 | Facility | None | $30.90 | $5,011.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Pacific Source Setting Facility Modifier None Typical Low $30.20 Median $51.29 Typical High $54.95 | Facility | None | $30.20 | $51.29 | $54.95 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $275.42 Typical High $1,047.13 | Facility | None | $112.20 | $275.42 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $128.82 | Professional | None | $64.57 | $79.43 | $128.82 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $912.01 Typical High $1,202.26 | Facility | None | $691.83 | $912.01 | $1,202.26 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $162.18 | Professional | None | $91.20 | $107.15 | $162.18 |
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 $32.36 Median $48.98 Typical High $204.17 | Professional | None | $32.36 | $48.98 | $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 $14.13 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 54 · Surgery only | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 54 · Surgery only | $21.38 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Where Oregon sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 26th of 51
$81.28
TN $288ME $31.62
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.