How much rates vary
Facilitymedian $178 · 10th to 90th $110 to $794Professionalmedian $132 · 10th to 90th $71 to $251
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $154.88 | Professional | None | $67.61 | $100.00 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $141.25 Typical High $660.69 | Facility | None | $112.20 | $141.25 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $269.15 | Professional | None | $75.86 | $144.54 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $245.47 | Professional | None | $89.13 | $134.90 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $218.78 Typical High $7,943.28 | Facility | None | $95.50 | $218.78 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $204.17 | Professional | None | $67.61 | $125.89 | $204.17 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $173.78 Typical High $194.98 | Facility | None | $109.65 | $173.78 | $194.98 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $660.69 | Facility | None | $102.33 | $144.54 | $660.69 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $263.03 | Professional | None | $77.62 | $138.04 | $263.03 |
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 $97.72 Median $169.82 Typical High $257.04 | Professional | None | $97.72 | $169.82 | $257.04 |
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 $87.10 Median $154.88 Typical High $281.84 | Professional | None | $87.10 | $154.88 | $281.84 |
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 $33.11 Median $47.86 Typical High $66.07 | Professional | 52 · Reduced service | $33.11 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.05 Typical High $26.30 | Professional | 53 · Discontinued | $13.49 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $70.79 Typical High $97.72 | Professional | 54 · Surgery only | $50.12 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $14.13 Typical High $19.95 | Professional | 55 · Aftercare only | $10.00 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.55 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.76 | $9.55 | $13.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $37.15 Typical High $66.07 | Professional | 52 · Reduced service | $33.11 | $37.15 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $26.30 | Professional | 53 · Discontinued | $13.49 | $14.79 | $26.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $54.95 Typical High $97.72 | Professional | 54 · Surgery only | $50.12 | $54.95 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $19.95 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $13.18 |
Where Oregon sits
The same service costs 2.8 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· 7th of 51
$148
WI $257KY $91.20
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.