How much rates vary
Facilitymedian $263 · 10th to 90th $174 to $1,995Professionalmedian $191 · 10th to 90th $102 to $355
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 $102.33 Median $154.88 Typical High $213.80 | Professional | None | $102.33 | $154.88 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $630.96 Typical High $794.33 | Facility | None | $467.74 | $630.96 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $380.19 | Professional | None | $114.82 | $199.53 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $338.84 | Professional | None | $138.04 | $213.80 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $6,606.93 | Facility | None | $147.91 | $263.03 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $281.84 | Professional | None | $102.33 | $173.78 | $281.84 |
Pacific Source Setting Facility Modifier None Typical Low $154.88 Median $245.47 Typical High $275.42 | Facility | None | $154.88 | $245.47 | $275.42 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $549.54 Typical High $794.33 | Facility | None | $190.55 | $549.54 | $794.33 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $363.08 | Professional | None | $79.43 | $199.53 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $2,691.53 | Facility | None | $1,659.59 | $2,344.23 | $2,691.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $363.08 | Professional | None | $151.36 | $257.04 | $363.08 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,630.78 | Facility | None | $354.81 | $660.69 | $3,630.78 |
United Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $389.05 | Professional | None | $131.83 | $223.87 | $389.05 |
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 $51.29 Median $67.61 Typical High $91.20 | Professional | 52 · Reduced service | $51.29 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $37.15 | Professional | 53 · Discontinued | $20.42 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $100.00 Typical High $138.04 | Professional | 54 · Surgery only | $77.62 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.95 Typical High $27.54 | Professional | 55 · Aftercare only | $15.49 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $18.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $91.20 | Professional | 52 · Reduced service | $51.29 | $51.29 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $37.15 | Professional | 53 · Discontinued | $20.42 | $20.89 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $138.04 | Professional | 54 · Surgery only | $77.62 | $77.62 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $27.54 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $18.20 |
Where Oregon sits
The same service costs 3.6 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· 6th of 51
$224
WI $417KY $115
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.