How much rates vary
Facilitymedian $13 · 10th to 90th $3 to $427Professionalmedian $14 · 10th to 90th $8 to $21
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 $8.91 Median $10.00 Typical High $10.00 | Professional | None | $8.91 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $19.95 | Professional | None | $7.59 | $8.71 | $19.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $20.42 | Professional | None | $12.88 | $16.60 | $20.42 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $19.05 Typical High $7,943.28 | Facility | None | $14.13 | $19.05 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $7.41 Median $10.00 Typical High $16.60 | Professional | None | $7.41 | $10.00 | $16.60 |
Pacific Source Setting Facility Modifier None Typical Low $2.63 Median $12.59 Typical High $15.49 | Facility | None | $2.63 | $12.59 | $15.49 |
Pacific Source Setting Professional Modifier None Typical Low $0.48 Median $2.63 Typical High $12.59 | Professional | None | $0.48 | $2.63 | $12.59 |
Providence Setting Facility Modifier None Typical Low $7.59 Median $18.20 Typical High $23.44 | Facility | None | $7.59 | $18.20 | $23.44 |
Providence Setting Professional Modifier None Typical Low $7.94 Median $12.88 Typical High $70.79 | Professional | None | $7.94 | $12.88 | $70.79 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $549.54 Typical High $630.96 | Facility | None | $407.38 | $549.54 | $630.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $14.13 Median $14.79 Typical High $15.49 | Professional | None | $14.13 | $14.79 | $15.49 |
United Setting Facility Modifier None Typical Low $407.38 Median $512.86 Typical High $630.96 | Facility | None | $407.38 | $512.86 | $630.96 |
United Setting Professional Modifier None Typical Low $11.75 Median $16.22 Typical High $25.12 | Professional | None | $11.75 | $16.22 | $25.12 |
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 $4.47 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $4.47 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.78 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.61 Median $7.41 Typical High $7.41 | Professional | 54 · Surgery only | $6.61 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.35 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.89 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 54 · Surgery only | $7.41 | $7.41 | $7.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Oregon sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 10th of 51
$14.13
HI $18.20NC $7.76
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.