How much rates vary
Facilitymedian $295 · 10th to 90th $200 to $537Professionalmedian $182 · 10th to 90th $79 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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $162.18 Typical High $251.19 | Professional | None | $66.07 | $162.18 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $204.17 Typical High $436.52 | Professional | None | $85.11 | $204.17 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $363.08 | Professional | None | $89.13 | $128.82 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $380.19 Typical High $7,943.28 | Facility | None | $131.83 | $380.19 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $70.79 Median $177.83 Typical High $316.23 | Professional | None | $70.79 | $177.83 | $316.23 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $346.74 | Facility | None | $204.17 | $295.12 | $346.74 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $181.97 Typical High $478.63 | Facility | None | $58.88 | $181.97 | $478.63 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $426.58 | Professional | None | $79.43 | $177.83 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $794.33 | Facility | None | $524.81 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $346.74 | Professional | None | $134.90 | $229.09 | $346.74 |
United Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $1,000.00 | Facility | None | $630.96 | $794.33 | $1,000.00 |
United Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $446.68 | Professional | None | $114.82 | $218.78 | $446.68 |
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 $45.71 Median $45.71 Typical High $117.49 | Professional | 52 · Reduced service | $45.71 | $45.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $46.77 | Professional | 53 · Discontinued | $18.20 | $18.20 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $173.78 | Professional | 54 · Surgery only | $69.18 | $69.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $34.67 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $45.71 Typical High $117.49 | Professional | 52 · Reduced service | $45.71 | $45.71 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $46.77 | Professional | 53 · Discontinued | $18.20 | $18.20 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $173.78 | Professional | 54 · Surgery only | $69.18 | $69.18 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $34.67 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $23.44 |
Where Oregon sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 4th of 51
$234
AK $288MD $83.18
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.