How much rates vary
Facilitymedian $617 · 10th to 90th $214 to $1,047Professionalmedian $288 · 10th to 90th $126 to $832
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 $154.88 Median $4,786.30 Typical High $7,943.28 | Facility | None | $154.88 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $302.00 Typical High $575.44 | Professional | None | $114.82 | $302.00 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $870.96 | Facility | None | $223.87 | $281.84 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $288.40 Typical High $851.14 | Professional | None | $125.89 | $288.40 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $933.25 | Professional | None | $158.49 | $239.88 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $831.76 Typical High $7,943.28 | Facility | None | $154.88 | $831.76 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $331.13 Typical High $707.95 | Professional | None | $125.89 | $331.13 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $380.19 Median $630.96 Typical High $676.08 | Facility | None | $380.19 | $630.96 | $676.08 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $288.40 Typical High $1,023.29 | Facility | None | $194.98 | $288.40 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $257.04 Typical High $912.01 | Professional | None | $100.00 | $257.04 | $912.01 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Facility | None | $691.83 | $851.14 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $676.08 | Professional | None | $165.96 | $323.59 | $676.08 |
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 $141.25 Median $346.74 Typical High $870.96 | Professional | None | $141.25 | $346.74 | $870.96 |
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 $63.10 Median $147.91 Typical High $288.40 | Professional | 52 · Reduced service | $63.10 | $147.91 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $58.88 Typical High $114.82 | Professional | 53 · Discontinued | $25.12 | $58.88 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $223.87 Typical High $436.52 | Professional | 54 · Surgery only | $93.33 | $223.87 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $44.67 Typical High $87.10 | Professional | 55 · Aftercare only | $19.05 | $44.67 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $29.51 Typical High $57.54 | Professional | 56 · Pre-op care only | $12.59 | $29.51 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $147.91 Typical High $288.40 | Professional | 52 · Reduced service | $63.10 | $147.91 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $58.88 Typical High $114.82 | Professional | 53 · Discontinued | $25.12 | $58.88 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $218.78 Typical High $436.52 | Professional | 54 · Surgery only | $93.33 | $218.78 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $44.67 Typical High $87.10 | Professional | 55 · Aftercare only | $19.05 | $44.67 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $29.51 Typical High $57.54 | Professional | 56 · Pre-op care only | $12.59 | $29.51 | $57.54 |
Where Oregon sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 7th of 51
$380
WI $479DC $100
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.