How much rates vary
Facilitymedian $162 · 10th to 90th $95 to $776Professionalmedian $135 · 10th to 90th $83 to $234
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 $67.61 Median $87.10 Typical High $120.23 | Professional | None | $67.61 | $87.10 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $660.69 | Facility | None | $77.62 | $97.72 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $245.47 | Professional | None | $91.20 | $147.91 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $218.78 | Professional | None | $104.71 | $147.91 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $186.21 Typical High $6,606.93 | Facility | None | $117.49 | $186.21 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $199.53 | Professional | None | $75.86 | $117.49 | $199.53 |
Pacific Source Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $177.83 | Facility | None | $97.72 | $158.49 | $177.83 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $707.95 | Facility | None | $79.43 | $114.82 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $234.42 | Professional | None | $79.43 | $147.91 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Facility | None | $691.83 | $851.14 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $234.42 | Professional | None | $120.23 | $169.82 | $234.42 |
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 $104.71 Median $162.18 Typical High $263.03 | Professional | None | $104.71 | $162.18 | $263.03 |
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 $40.74 Median $44.67 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.20 Typical High $23.44 | Professional | 53 · Discontinued | $16.60 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $67.61 Typical High $87.10 | Professional | 54 · Surgery only | $61.66 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $9.12 | $11.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | 52 · Reduced service | $40.74 | $40.74 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $23.44 | Professional | 53 · Discontinued | $16.60 | $16.60 | $23.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $87.10 | Professional | 54 · Surgery only | $61.66 | $61.66 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $11.75 |
Where Oregon sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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· 6th of 51
$151
WI $269FL $75.86
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.