How much rates vary
Facilitymedian $162 · 10th to 90th $98 to $537Professionalmedian $132 · 10th to 90th $71 to $240
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $77.62 Typical High $112.20 | Professional | None | $58.88 | $77.62 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $104.71 Typical High $660.69 | Facility | None | $83.18 | $104.71 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $251.19 | Professional | None | $81.28 | $138.04 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $223.87 | Professional | None | $91.20 | $141.25 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $7,943.28 | Facility | None | $95.50 | $154.88 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $204.17 | Professional | None | $64.57 | $107.15 | $204.17 |
Pacific Source Setting Facility Modifier None Typical Low $102.33 Median $162.18 Typical High $186.21 | Facility | None | $102.33 | $162.18 | $186.21 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $117.49 Typical High $660.69 | Facility | None | $83.18 | $117.49 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $245.47 | Professional | None | $79.43 | $138.04 | $245.47 |
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 $109.65 Median $177.83 Typical High $245.47 | Professional | None | $109.65 | $177.83 | $245.47 |
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 $97.72 Median $154.88 Typical High $263.03 | Professional | None | $97.72 | $154.88 | $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 $33.11 Median $38.02 Typical High $53.70 | Professional | 52 · Reduced service | $33.11 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.49 Typical High $21.38 | Professional | 53 · Discontinued | $13.18 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $57.54 Typical High $81.28 | Professional | 54 · Surgery only | $50.12 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.48 Typical High $16.22 | Professional | 55 · Aftercare only | $10.00 | $11.48 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.76 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.61 | $7.76 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $33.11 Typical High $53.70 | Professional | 52 · Reduced service | $33.11 | $33.11 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $21.38 | Professional | 53 · Discontinued | $13.18 | $13.18 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | 54 · Surgery only | $50.12 | $50.12 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $16.22 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $10.72 |
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· 7th of 51
$148
WI $240DC $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.