How much rates vary
Facilitymedian $759 · 10th to 90th $550 to $12,589Professionalmedian $708 · 10th to 90th $363 to $1,072
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 $616.60 Median $8,912.51 Typical High $18,620.87 | Facility | None | $616.60 | $8,912.51 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $616.60 | Professional | None | $416.87 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $5,128.61 Typical High $6,918.31 | Facility | None | $1,230.27 | $5,128.61 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,047.13 | Professional | None | $524.81 | $691.83 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $891.25 | Professional | None | $630.96 | $741.31 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $7,943.28 Typical High $17,782.79 | Facility | None | $676.08 | $7,943.28 | $17,782.79 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $954.99 | Professional | None | $426.58 | $524.81 | $954.99 |
Pacific Source Setting Facility Modifier None Typical Low $457.09 Median $758.58 Typical High $776.25 | Facility | None | $457.09 | $758.58 | $776.25 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $4,677.35 Typical High $6,918.31 | Facility | None | $812.83 | $4,677.35 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $724.44 Typical High $1,122.02 | Professional | None | $79.43 | $724.44 | $1,122.02 |
Regence BlueShield Setting Facility Modifier None Typical Low $12,589.25 Median $17,782.79 Typical High $20,417.38 | Facility | None | $12,589.25 | $17,782.79 | $20,417.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,148.15 | Professional | None | $741.31 | $776.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,801.89 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,801.89 | $22,908.68 |
United Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,348.96 | Professional | None | $575.44 | $831.76 | $1,348.96 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $18,620.87 Median $26,915.35 Typical High $30,199.52 | Facility | 50 · Both sides | $18,620.87 | $26,915.35 | $30,199.52 |
Where Oregon sits
The same service costs 7.3 times more in Wisconsin than in Montana. 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
WI $8,816MT $1,205
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.