How much rates vary
Facilitymedian $417 · 10th to 90th $110 to $3,548Professionalmedian $251 · 10th to 90th $115 to $437
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 $128.82 Median $169.82 Typical High $169.82 | Professional | None | $128.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $954.99 Typical High $1,288.25 | Facility | None | $549.54 | $954.99 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $407.38 | Professional | None | $199.53 | $263.03 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $346.74 | Professional | None | $245.47 | $281.84 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $4,677.35 Typical High $7,943.28 | Facility | None | $186.21 | $4,677.35 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $602.56 | Professional | None | $128.82 | $169.82 | $602.56 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $269.15 | Facility | None | $81.28 | $134.90 | $269.15 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $912.01 Typical High $1,380.38 | Facility | None | $346.74 | $912.01 | $1,380.38 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $213.80 Typical High $436.52 | Professional | None | $79.43 | $213.80 | $436.52 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $3,235.94 | Facility | None | $1,905.46 | $2,691.53 | $3,235.94 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $436.52 | Professional | None | $281.84 | $295.12 | $436.52 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $512.86 | Professional | None | $213.80 | $281.84 | $512.86 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $74.13 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $16.98 |
Where Oregon sits
The same service costs 4.3 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· 20th of 51
$269
AK $603NY $141
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.