How much rates vary
Facilitymedian $145 · 10th to 90th $87 to $741Professionalmedian $91 · 10th to 90th $43 to $204
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 $67.61 Median $4,265.80 Typical High $7,943.28 | Facility | None | $67.61 | $4,265.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $131.83 | Professional | None | $39.81 | $70.79 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $154.88 | Facility | None | $85.11 | $109.65 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $89.13 Typical High $213.80 | Professional | None | $42.66 | $89.13 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $190.55 | Professional | None | $48.98 | $75.86 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $177.83 Typical High $6,606.93 | Facility | None | $67.61 | $177.83 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $95.50 Typical High $181.97 | Professional | None | $39.81 | $95.50 | $181.97 |
Pacific Source Setting Facility Modifier None Typical Low $87.10 Median $141.25 Typical High $158.49 | Facility | None | $87.10 | $141.25 | $158.49 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $114.82 Typical High $186.21 | Facility | None | $61.66 | $114.82 | $186.21 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $208.93 | Professional | None | $52.48 | $87.10 | $208.93 |
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 $56.23 Median $102.33 Typical High $204.17 | Professional | None | $56.23 | $102.33 | $204.17 |
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 $53.70 Median $102.33 Typical High $218.78 | Professional | None | $53.70 | $102.33 | $218.78 |
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 $19.95 Median $31.62 Typical High $53.70 | Professional | 52 · Reduced service | $19.95 | $31.62 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $12.59 Typical High $21.38 | Professional | 53 · Discontinued | $7.94 | $12.59 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $47.86 Typical High $79.43 | Professional | 54 · Surgery only | $29.51 | $47.86 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $9.55 Typical High $16.22 | Professional | 55 · Aftercare only | $5.89 | $9.55 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.31 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.98 | $6.31 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $38.02 Typical High $53.70 | Professional | 52 · Reduced service | $19.95 | $38.02 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.55 Typical High $21.38 | Professional | 53 · Discontinued | $7.94 | $9.55 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $35.48 Typical High $79.43 | Professional | 54 · Surgery only | $29.51 | $35.48 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.08 Typical High $16.22 | Professional | 55 · Aftercare only | $5.89 | $7.08 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.68 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.98 | $4.68 | $10.72 |
Where Oregon sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 6th of 51
$115
WI $186NE $60.26
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.