How much rates vary
Facilitymedian $162 · 10th to 90th $138 to $575Professionalmedian $85 · 10th to 90th $38 to $234
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 $109.65 Median $109.65 Typical High $141.25 | Facility | None | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $107.15 | Professional | None | $34.67 | $43.65 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $239.88 | Professional | None | $85.11 | $85.11 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $218.78 | Professional | None | $151.36 | $190.55 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $42.66 Median $251.19 Typical High $575.44 | Facility | None | $42.66 | $251.19 | $575.44 |
Moda Health Setting Professional Modifier None Typical Low $34.67 Median $100.00 Typical High $112.20 | Professional | None | $34.67 | $100.00 | $112.20 |
Pacific Source Setting Facility Modifier None Typical Low $138.04 Median $162.18 Typical High $169.82 | Facility | None | $138.04 | $162.18 | $169.82 |
Providence Setting Facility Modifier None Typical Low $89.13 Median $104.71 Typical High $151.36 | Facility | None | $89.13 | $104.71 | $151.36 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $245.47 | Professional | None | $70.79 | $85.11 | $245.47 |
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 $158.49 Median $169.82 Typical High $213.80 | Professional | None | $158.49 | $169.82 | $213.80 |
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 $38.02 Median $85.11 Typical High $275.42 | Professional | None | $38.02 | $85.11 | $275.42 |
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 $18.62 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $18.62 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $7.41 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $81.28 Typical High $81.28 | Professional | 54 · Surgery only | $27.54 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $5.62 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.72 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $17.38 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $6.92 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $81.28 Typical High $81.28 | Professional | 54 · Surgery only | $25.70 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $5.13 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.47 | $10.72 | $10.72 |
Where Oregon sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 2nd of 51
$138
AK $141OH $31.62
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.