How much rates vary
Facilitymedian $162 · 10th to 90th $100 to $302Professionalmedian $126 · 10th to 90th $83 to $214
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 Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $147.91 | Professional | None | $63.10 | $95.50 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $134.90 Typical High $186.21 | Facility | None | $95.50 | $134.90 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $213.80 | Professional | None | $93.33 | $134.90 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $245.47 | Professional | None | $117.49 | $165.96 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $251.19 | Facility | None | $95.50 | $151.36 | $251.19 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $208.93 | Professional | None | $83.18 | $123.03 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $177.83 | Facility | None | $100.00 | $162.18 | $177.83 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $141.25 Typical High $218.78 | Facility | None | $95.50 | $141.25 | $218.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $213.80 | Professional | None | $79.43 | $134.90 | $213.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,047.13 | Facility | None | $691.83 | $933.25 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $186.21 | Professional | None | $120.23 | $169.82 | $186.21 |
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 $91.20 Median $134.90 Typical High $229.09 | Professional | None | $91.20 | $134.90 | $229.09 |
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 $43.65 Median $43.65 Typical High $61.66 | Professional | 52 · Reduced service | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $18.62 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $61.66 | Professional | 52 · Reduced service | $43.65 | $43.65 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $17.38 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $18.62 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $12.30 |
Moda Health Setting Professional Modifier 58 · Staged procedure Typical Low $100.00 Median $263.03 Typical High $389.05 | Professional | 58 · Staged procedure | $100.00 | $263.03 | $389.05 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $1,023.29 Median $1,412.54 Typical High $1,584.89 | Facility | 50 · Both sides | $1,023.29 | $1,412.54 | $1,584.89 |
Where Oregon sits
The same service costs 3.7 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· 8th of 51
$135
AK $257KY $69.18
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.