How much rates vary
Facilitymedian $234 · 10th to 90th $151 to $851Professionalmedian $240 · 10th to 90th $123 to $363
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 $123.03 Median $158.49 Typical High $158.49 | Professional | None | $123.03 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $2,137.96 | Facility | None | $549.54 | $870.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $331.13 | Professional | None | $165.96 | $218.78 | $331.13 |
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 $173.78 Median $302.00 Typical High $7,943.28 | Facility | None | $173.78 | $302.00 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $331.13 | Professional | None | $158.49 | $190.55 | $331.13 |
Pacific Source Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $251.19 | Facility | None | $147.91 | $234.42 | $251.19 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $302.00 Typical High $1,047.13 | Facility | None | $147.91 | $302.00 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $363.08 | Professional | None | $79.43 | $234.42 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $380.19 | Professional | None | $239.88 | $251.19 | $380.19 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $436.52 | Professional | None | $186.21 | $275.42 | $436.52 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Oregon sits
The same service costs 3.9 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· 11th of 51
$234
AK $513NY $132
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.