How much rates vary
Facilitymedian $79 · 10th to 90th $51 to $457Professionalmedian $68 · 10th to 90th $37 to $107
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 $31.62 Median $52.48 Typical High $64.57 | Professional | None | $31.62 | $52.48 | $64.57 |
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 $32.36 Median $61.66 Typical High $114.82 | Professional | None | $32.36 | $61.66 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $102.33 | Professional | None | $60.26 | $79.43 | $102.33 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $87.10 Typical High $7,943.28 | Facility | None | $60.26 | $87.10 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $57.54 Typical High $93.33 | Professional | None | $36.31 | $57.54 | $93.33 |
Pacific Source Setting Facility Modifier None Typical Low $47.86 Median $77.62 Typical High $83.18 | Facility | None | $47.86 | $77.62 | $83.18 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $407.38 | Facility | None | $56.23 | $87.10 | $407.38 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $109.65 | Professional | None | $46.77 | $72.44 | $109.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $1,000.00 Typical High $1,621.81 | Facility | None | $323.59 | $1,000.00 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $93.33 | Professional | None | $64.57 | $79.43 | $93.33 |
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 $51.29 Median $72.44 Typical High $117.49 | Professional | None | $51.29 | $72.44 | $117.49 |
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 $25.70 Median $26.30 Typical High $32.36 | Professional | 52 · Reduced service | $25.70 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.47 Typical High $12.88 | Professional | 53 · Discontinued | $10.23 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $39.81 Typical High $48.98 | Professional | 54 · Surgery only | $38.02 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.94 Typical High $9.77 | Professional | 55 · Aftercare only | $7.76 | $7.94 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.25 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.13 | $5.25 | $6.46 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.30 Typical High $32.36 | Professional | 52 · Reduced service | $26.30 | $26.30 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $12.88 | Professional | 53 · Discontinued | $10.47 | $10.47 | $12.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $48.98 | Professional | 54 · Surgery only | $39.81 | $39.81 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $9.77 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $9.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $6.46 |
Where Oregon sits
The same service costs 3.8 times more in Alaska than in Utah. 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
$70.79
AK $135UT $35.48
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.