How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,288 to $6,026Professionalmedian $813 · 10th to 90th $331 to $3,020
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 $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,023.29 Typical High $1,659.59 | Professional | None | $281.84 | $1,023.29 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $3,311.31 Typical High $4,365.16 | Facility | None | $1,023.29 | $3,311.31 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $812.83 Typical High $3,162.28 | Professional | None | $354.81 | $812.83 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $2,691.53 | Professional | None | $416.87 | $630.96 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $5,128.61 Typical High $8,709.64 | Facility | None | $467.74 | $5,128.61 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $794.33 Typical High $2,398.83 | Professional | None | $331.13 | $794.33 | $2,398.83 |
Pacific Source Setting Facility Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $2,238.72 | Facility | None | $1,288.25 | $2,041.74 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,951.21 Typical High $4,677.35 | Facility | None | $630.96 | $2,951.21 | $4,677.35 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $724.44 Typical High $3,162.28 | Professional | None | $79.43 | $724.44 | $3,162.28 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,754.40 Median $12,022.64 Typical High $13,803.84 | Facility | None | $5,754.40 | $12,022.64 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $851.14 Typical High $3,019.95 | Professional | None | $467.74 | $851.14 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $426.58 Median $1,096.48 Typical High $3,090.30 | Professional | None | $426.58 | $1,096.48 | $3,090.30 |
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 $165.96 Median $194.98 Typical High $831.76 | Professional | 52 · Reduced service | $165.96 | $194.98 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $77.62 Typical High $331.13 | Professional | 53 · Discontinued | $66.07 | $77.62 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $288.40 Typical High $1,230.27 | Professional | 54 · Surgery only | $245.47 | $288.40 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $58.88 Typical High $245.47 | Professional | 55 · Aftercare only | $48.98 | $58.88 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $33.11 | $38.90 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $831.76 | Professional | 52 · Reduced service | $165.96 | $165.96 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $331.13 | Professional | 53 · Discontinued | $66.07 | $66.07 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $1,230.27 | Professional | 54 · Surgery only | $245.47 | $245.47 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $245.47 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $165.96 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $165.96 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $8,511.38 Median $18,197.01 Typical High $20,892.96 | Facility | 50 · Both sides | $8,511.38 | $18,197.01 | $20,892.96 |
Where Oregon sits
The same service costs 3.2 times more in Oklahoma 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.
Physician feeFacility fee
OK $6,075KY $1,891
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.