How much rates vary
Facilitymedian $158 · 10th to 90th $93 to $363Professionalmedian $120 · 10th to 90th $68 to $224
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 $69.18 Median $158.49 Typical High $7,943.28 | Facility | None | $69.18 | $158.49 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $144.54 | Professional | None | $53.70 | $100.00 | $144.54 |
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 $69.18 Median $120.23 Typical High $223.87 | Professional | None | $69.18 | $120.23 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $199.53 | Professional | None | $79.43 | $120.23 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $223.87 Typical High $371.54 | Facility | None | $91.20 | $223.87 | $371.54 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $120.23 Typical High $223.87 | Professional | None | $63.10 | $120.23 | $223.87 |
Pacific Source Setting Facility Modifier None Typical Low $93.33 Median $154.88 Typical High $190.55 | Facility | None | $93.33 | $154.88 | $190.55 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $162.18 Typical High $562.34 | Facility | None | $61.66 | $162.18 | $562.34 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $229.09 | Professional | None | $70.79 | $123.03 | $229.09 |
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 $91.20 Median $154.88 Typical High $213.80 | Professional | None | $91.20 | $154.88 | $213.80 |
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 $77.62 Median $138.04 Typical High $257.04 | Professional | None | $77.62 | $138.04 | $257.04 |
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 $33.88 Median $33.88 Typical High $60.26 | Professional | 52 · Reduced service | $33.88 | $33.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $23.99 | Professional | 53 · Discontinued | $13.49 | $13.49 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $91.20 | Professional | 54 · Surgery only | $50.12 | $50.12 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $18.20 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $35.48 Typical High $60.26 | Professional | 52 · Reduced service | $33.88 | $35.48 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $23.99 | Professional | 53 · Discontinued | $13.49 | $13.49 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $91.20 | Professional | 54 · Surgery only | $50.12 | $50.12 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $18.20 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $12.02 |
Where Oregon sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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
$135
AK $214KY $64.57
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.