How much rates vary
Facilitymedian $135 · 10th to 90th $81 to $363Professionalmedian $105 · 10th to 90th $58 to $200
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $100.00 | Professional | None | $52.48 | $70.79 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $109.65 Typical High $208.93 | Professional | None | $57.54 | $109.65 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $190.55 | Professional | None | $69.18 | $104.71 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $141.25 Typical High $7,943.28 | Facility | None | $74.13 | $141.25 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $141.25 | Professional | None | $52.48 | $100.00 | $141.25 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $131.83 Typical High $151.36 | Facility | None | $81.28 | $131.83 | $151.36 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $117.49 Typical High $741.31 | Facility | None | $57.54 | $117.49 | $741.31 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $104.71 Typical High $199.53 | Professional | None | $64.57 | $104.71 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $512.86 | Facility | None | $323.59 | $446.68 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $128.82 Typical High $199.53 | Professional | None | $75.86 | $128.82 | $199.53 |
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 $67.61 Median $114.82 Typical High $213.80 | Professional | None | $67.61 | $114.82 | $213.80 |
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 $26.30 Median $28.84 Typical High $50.12 | Professional | 52 · Reduced service | $26.30 | $28.84 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.48 Typical High $19.95 | Professional | 53 · Discontinued | $10.47 | $11.48 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $42.66 Typical High $75.86 | Professional | 54 · Surgery only | $38.90 | $42.66 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.51 Typical High $15.14 | Professional | 55 · Aftercare only | $7.76 | $8.51 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.75 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.25 | $5.75 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.30 Typical High $50.12 | Professional | 52 · Reduced service | $26.30 | $26.30 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $19.95 | Professional | 53 · Discontinued | $10.47 | $10.47 | $19.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $75.86 | Professional | 54 · Surgery only | $38.90 | $38.90 | $75.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $15.14 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $10.00 |
Where Oregon sits
The same service costs 3.4 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
$123
WI $209KY $61.66
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.