How much rates vary
Facilitymedian $178 · 10th to 90th $100 to $3,236Professionalmedian $126 · 10th to 90th $59 to $288
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 $83.18 Median $251.19 Typical High $6,606.93 | Facility | None | $83.18 | $251.19 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $154.88 | Professional | None | $51.29 | $74.13 | $154.88 |
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 $72.44 Median $138.04 Typical High $309.03 | Professional | None | $72.44 | $138.04 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $257.04 | Professional | None | $83.18 | $125.89 | $257.04 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $1,621.81 Typical High $6,606.93 | Facility | None | $117.49 | $1,621.81 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $120.23 Typical High $275.42 | Professional | None | $57.54 | $120.23 | $275.42 |
Pacific Source Setting Facility Modifier None Typical Low $100.00 Median $173.78 Typical High $213.80 | Facility | None | $100.00 | $173.78 | $213.80 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $138.04 Typical High $194.98 | Facility | None | $58.88 | $138.04 | $194.98 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $128.82 Typical High $295.12 | Professional | None | $72.44 | $128.82 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $158.49 Median $234.42 Typical High $436.52 | Facility | None | $158.49 | $234.42 | $436.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $295.12 | Professional | None | $95.50 | $162.18 | $295.12 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $309.03 | Professional | None | $87.10 | $141.25 | $309.03 |
12 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 $29.51 Median $33.11 Typical High $63.10 | Professional | 52 · Reduced service | $29.51 | $33.11 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $25.12 | Professional | 53 · Discontinued | $12.02 | $13.18 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $50.12 Typical High $93.33 | Professional | 54 · Surgery only | $44.67 | $50.12 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.00 Typical High $18.62 | Professional | 55 · Aftercare only | $8.91 | $10.00 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.61 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.89 | $6.61 | $12.59 |
Moda Health Setting Professional Modifier 51 · Multiple procedures Typical Low $48.98 Median $144.54 Typical High $354.81 | Professional | 51 · Multiple procedures | $48.98 | $144.54 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $29.51 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $25.12 Typical High $58.88 | Professional | 53 · Discontinued | $12.02 | $25.12 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $93.33 | Professional | 54 · Surgery only | $44.67 | $44.67 | $93.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $18.62 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $12.59 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $47.86 Median $112.20 Typical High $154.88 | Professional | 59 · Distinct service | $47.86 | $112.20 | $154.88 |
Where Oregon sits
The same service costs 3.2 times more in Alaska than in New York. 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
$138
AK $251NY $77.62
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.