How much rates vary
Facilitymedian $58 · 10th to 90th $34 to $457Professionalmedian $51 · 10th to 90th $35 to $79
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 $29.51 Median $41.69 Typical High $44.67 | Professional | None | $29.51 | $41.69 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,047.13 | Facility | None | $446.68 | $660.69 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $45.71 Typical High $81.28 | Professional | None | $23.44 | $45.71 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $70.79 | Professional | None | $45.71 | $56.23 | $70.79 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $70.79 Typical High $7,943.28 | Facility | None | $44.67 | $70.79 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $74.13 | Professional | None | $34.67 | $44.67 | $74.13 |
Pacific Source Setting Facility Modifier None Typical Low $33.88 Median $54.95 Typical High $57.54 | Facility | None | $33.88 | $54.95 | $57.54 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $70.79 Typical High $707.95 | Facility | None | $42.66 | $70.79 | $707.95 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $79.43 | Professional | None | $35.48 | $53.70 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $70.79 | Professional | None | $51.29 | $54.95 | $70.79 |
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 $38.90 Median $53.70 Typical High $93.33 | Professional | None | $38.90 | $53.70 | $93.33 |
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 $18.20 Median $20.89 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $8.51 Typical High $8.91 | Professional | 53 · Discontinued | $7.24 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $31.62 Typical High $33.88 | Professional | 54 · Surgery only | $27.54 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.31 Typical High $6.76 | Professional | 55 · Aftercare only | $5.50 | $6.31 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.17 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.63 | $4.17 | $4.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $20.89 Typical High $22.39 | Professional | 52 · Reduced service | $20.89 | $20.89 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | 54 · Surgery only | $31.62 | $31.62 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.76 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.47 |
Where Oregon sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 7th of 51
$53.70
AK $110NJ $26.92
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.