How much rates vary
Facilitymedian $501 · 10th to 90th $295 to $1,202Professionalmedian $372 · 10th to 90th $195 to $741
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $416.87 | Professional | None | $138.04 | $229.09 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $446.68 Typical High $891.25 | Facility | None | $354.81 | $446.68 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $776.25 | Professional | None | $194.98 | $371.54 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $660.69 | Professional | None | $223.87 | $338.84 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $602.56 Typical High $8,709.64 | Facility | None | $281.84 | $602.56 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $537.03 | Professional | None | $194.98 | $346.74 | $537.03 |
Pacific Source Setting Facility Modifier None Typical Low $302.00 Median $501.19 Typical High $549.54 | Facility | None | $302.00 | $501.19 | $549.54 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $891.25 | Facility | None | $295.12 | $446.68 | $891.25 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $741.31 | Professional | None | $79.43 | $354.81 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,698.24 | Facility | None | $1,122.02 | $1,412.54 | $1,698.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $741.31 | Professional | None | $257.04 | $436.52 | $741.31 |
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 $223.87 Median $398.11 Typical High $776.25 | Professional | None | $223.87 | $398.11 | $776.25 |
11 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 $100.00 Median $100.00 Typical High $208.93 | Professional | 52 · Reduced service | $100.00 | $100.00 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $83.18 | Professional | 53 · Discontinued | $39.81 | $39.81 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $316.23 | Professional | 54 · Surgery only | $147.91 | $147.91 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $63.10 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $41.69 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $41.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $208.93 | Professional | 52 · Reduced service | $100.00 | $100.00 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $83.18 | Professional | 53 · Discontinued | $39.81 | $39.81 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $316.23 | Professional | 54 · Surgery only | $147.91 | $147.91 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $63.10 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $41.69 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $41.69 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $1,698.24 Median $2,137.96 Typical High $2,511.89 | Facility | 50 · Both sides | $1,698.24 | $2,137.96 | $2,511.89 |
Where Oregon sits
The same service costs 3.2 times more in Wisconsin 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· 4th of 51
$427
WI $646KY $204
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.