How much rates vary
Facilitymedian $282 · 10th to 90th $158 to $437Professionalmedian $178 · 10th to 90th $83 to $380
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 $79.43 Median $112.20 Typical High $190.55 | Professional | None | $79.43 | $112.20 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $190.55 Typical High $416.87 | Professional | None | $95.50 | $190.55 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $398.11 | Professional | None | $112.20 | $158.49 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $275.42 Typical High $7,943.28 | Facility | None | $117.49 | $275.42 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $181.97 Typical High $309.03 | Professional | None | $83.18 | $181.97 | $309.03 |
Pacific Source Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $302.00 | Facility | None | $169.82 | $275.42 | $302.00 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $181.97 Typical High $407.38 | Facility | None | $87.10 | $181.97 | $407.38 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $389.05 | Professional | None | $79.43 | $181.97 | $389.05 |
Regence BlueShield Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $602.56 | Facility | None | $257.04 | $371.54 | $602.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $371.54 | Professional | None | $123.03 | $194.98 | $371.54 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $87.10 | Facility | None | $58.88 | $58.88 | $87.10 |
United Setting Professional Modifier None Typical Low $83.18 Median $177.83 Typical High $398.11 | Professional | None | $83.18 | $177.83 | $398.11 |
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 $39.81 Median $51.29 Typical High $95.50 | Professional | 52 · Reduced service | $39.81 | $51.29 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $38.90 | Professional | 53 · Discontinued | $15.85 | $20.89 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $77.62 Typical High $144.54 | Professional | 54 · Surgery only | $60.26 | $77.62 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $28.84 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.23 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.94 | $10.23 | $19.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $41.69 Typical High $95.50 | Professional | 52 · Reduced service | $40.74 | $41.69 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.60 Typical High $38.90 | Professional | 53 · Discontinued | $16.22 | $16.60 | $38.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $63.10 Typical High $144.54 | Professional | 54 · Surgery only | $61.66 | $63.10 | $144.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.59 Typical High $28.84 | Professional | 55 · Aftercare only | $12.30 | $12.59 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.32 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.13 | $8.32 | $19.05 |
Where Oregon sits
The same service costs 3.5 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· 5th of 51
$191
AK $263KY $75.86
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.