How much rates vary
Facilitymedian $331 · 10th to 90th $204 to $871Professionalmedian $324 · 10th to 90th $174 to $479
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | None | $223.87 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $891.25 Typical High $1,047.13 | Facility | None | $602.56 | $891.25 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $478.63 | Professional | None | $181.97 | $288.40 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $407.38 | Professional | None | $288.40 | $338.84 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $501.19 Typical High $8,709.64 | Facility | None | $295.12 | $501.19 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $407.38 | Professional | None | $239.88 | $269.15 | $407.38 |
Pacific Source Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $354.81 | Facility | None | $213.80 | $323.59 | $354.81 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $457.09 Typical High $1,047.13 | Facility | None | $223.87 | $457.09 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $309.03 Typical High $478.63 | Professional | None | $79.43 | $309.03 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $457.09 | Professional | None | $338.84 | $354.81 | $457.09 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $512.86 | Professional | None | $208.93 | $323.59 | $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 $104.71 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $47.86 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $23.99 |
Where Oregon sits
The same service costs 4.5 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· 8th of 51
$331
AK $724NY $162
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.