How much rates vary
Facilitymedian $132 · 10th to 90th $74 to $389Professionalmedian $105 · 10th to 90th $56 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 $104.71 Median $169.82 Typical High $7,943.28 | Facility | None | $104.71 | $169.82 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $104.71 | Professional | None | $46.77 | $70.79 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $72.44 Typical High $100.00 | Facility | None | $58.88 | $72.44 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $204.17 | Professional | None | $64.57 | $109.65 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $169.82 | Professional | None | $74.13 | $112.20 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $131.83 Typical High $275.42 | Facility | None | $75.86 | $131.83 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $190.55 | Professional | None | $53.70 | $87.10 | $190.55 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $131.83 Typical High $151.36 | Facility | None | $81.28 | $131.83 | $151.36 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $181.97 | Facility | None | $58.88 | $77.62 | $181.97 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $199.53 | Professional | None | $70.79 | $112.20 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $794.33 | Facility | None | $489.78 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $199.53 | Professional | None | $87.10 | $141.25 | $199.53 |
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 $77.62 Median $123.03 Typical High $213.80 | Professional | None | $77.62 | $123.03 | $213.80 |
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 $26.92 Median $30.90 Typical High $42.66 | Professional | 52 · Reduced service | $26.92 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $12.30 Typical High $17.38 | Professional | 53 · Discontinued | $10.72 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $46.77 Typical High $64.57 | Professional | 54 · Surgery only | $39.81 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $9.33 Typical High $12.88 | Professional | 55 · Aftercare only | $7.94 | $9.33 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.17 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.37 | $6.17 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $26.92 Typical High $42.66 | Professional | 52 · Reduced service | $26.92 | $26.92 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $17.38 | Professional | 53 · Discontinued | $10.72 | $10.72 | $17.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $64.57 | Professional | 54 · Surgery only | $39.81 | $39.81 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $12.88 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $8.71 |
Where Oregon sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$117
WI $200DC $64.57
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.