How much rates vary
Facilitymedian $60 · 10th to 90th $31 to $417Professionalmedian $45 · 10th to 90th $32 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 $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 $25.12 Median $34.67 Typical High $58.88 | Professional | None | $25.12 | $34.67 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $39.81 Typical High $63.10 | Professional | None | $29.51 | $39.81 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $51.29 | Professional | None | $35.48 | $41.69 | $51.29 |
Moda Health Setting Facility Modifier None Typical Low $35.48 Median $120.23 Typical High $7,943.28 | Facility | None | $35.48 | $120.23 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $79.43 | Professional | None | $30.90 | $41.69 | $79.43 |
Pacific Source Setting Facility Modifier None Typical Low $30.90 Median $40.74 Typical High $95.50 | Facility | None | $30.90 | $40.74 | $95.50 |
Providence Setting Facility Modifier None Typical Low $33.88 Median $104.71 Typical High $616.60 | Facility | None | $33.88 | $104.71 | $616.60 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $53.70 Typical High $91.20 | Professional | None | $33.88 | $53.70 | $91.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $512.86 | Facility | None | $323.59 | $446.68 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $54.95 | Professional | None | $35.48 | $41.69 | $54.95 |
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 $40.74 Median $53.70 Typical High $95.50 | Professional | None | $40.74 | $53.70 | $95.50 |
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 $16.22 Median $17.38 Typical High $20.89 | Professional | 52 · Reduced service | $16.22 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.92 Typical High $8.32 | Professional | 53 · Discontinued | $6.46 | $6.92 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $26.30 Typical High $31.62 | Professional | 54 · Surgery only | $24.55 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.25 Typical High $6.31 | Professional | 55 · Aftercare only | $4.90 | $5.25 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.47 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $3.47 | $4.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.98 Typical High $17.38 | Professional | 52 · Reduced service | $16.22 | $16.98 | $17.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.76 Typical High $6.92 | Professional | 53 · Discontinued | $6.46 | $6.76 | $6.92 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $25.12 Typical High $26.30 | Professional | 54 · Surgery only | $24.55 | $25.12 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.13 Typical High $5.25 | Professional | 55 · Aftercare only | $4.90 | $5.13 | $5.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.39 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.24 | $3.39 | $3.47 |
Where Oregon sits
The same service costs 4.3 times more in Wyoming 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· 23rd of 51
$45.71
WY $89.13NY $20.89
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.