How much rates vary
Facilitymedian $331 · 10th to 90th $209 to $1,000Professionalmedian $339 · 10th to 90th $178 to $525
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 $186.21 Median $186.21 Typical High $229.09 | Professional | None | $186.21 | $186.21 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $331.13 Typical High $426.58 | Facility | None | $269.15 | $331.13 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $467.74 | Professional | None | $234.42 | $309.03 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $398.11 | Professional | None | $288.40 | $331.13 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $501.19 Typical High $7,943.28 | Facility | None | $263.03 | $501.19 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $478.63 | Professional | None | $186.21 | $263.03 | $478.63 |
Pacific Source Setting Facility Modifier None Typical Low $208.93 Median $331.13 Typical High $354.81 | Facility | None | $208.93 | $331.13 | $354.81 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $338.84 Typical High $457.09 | Facility | None | $251.19 | $338.84 | $457.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $338.84 Typical High $524.81 | Professional | None | $79.43 | $338.84 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,258.93 | Facility | None | $812.83 | $1,122.02 | $1,258.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $537.03 | Professional | None | $338.84 | $354.81 | $537.03 |
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 $263.03 Median $380.19 Typical High $616.60 | Professional | None | $263.03 | $380.19 | $616.60 |
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 $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $37.15 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 54 · Surgery only | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
Where Oregon sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 10th of 51
$331
AK $562TX $178
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.