How much rates vary
Facilitymedian $219 · 10th to 90th $151 to $2,188Professionalmedian $219 · 10th to 90th $115 to $339
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 $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $741.31 Typical High $1,000.00 | Facility | None | $588.84 | $741.31 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $302.00 | Professional | None | $154.88 | $204.17 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $281.84 | Professional | None | $204.17 | $234.42 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $302.00 Typical High $7,943.28 | Facility | None | $158.49 | $302.00 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $323.59 | Professional | None | $144.54 | $181.97 | $323.59 |
Pacific Source Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $229.09 | Facility | None | $131.83 | $199.53 | $229.09 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $691.83 Typical High $1,047.13 | Facility | None | $229.09 | $691.83 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $208.93 Typical High $338.84 | Professional | None | $79.43 | $208.93 | $338.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $2,818.38 | Facility | None | $1,819.70 | $2,454.71 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $346.74 | Professional | None | $218.78 | $229.09 | $346.74 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,630.78 | Facility | None | $354.81 | $660.69 | $3,630.78 |
United Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $398.11 | Professional | None | $165.96 | $229.09 | $398.11 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $109.65 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Where Oregon sits
The same service costs 4.4 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
$219
AK $513NY $117
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.