How much rates vary
Facilitymedian $145 · 10th to 90th $105 to $4,786Professionalmedian $141 · 10th to 90th $79 to $219
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 $100.00 Median $104.71 Typical High $104.71 | Professional | None | $100.00 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,344.23 Typical High $3,162.28 | Facility | None | $660.69 | $2,344.23 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $204.17 | Professional | None | $102.33 | $138.04 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $173.78 | Professional | None | $125.89 | $144.54 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $199.53 Typical High $7,943.28 | Facility | None | $117.49 | $199.53 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $218.78 | Professional | None | $104.71 | $117.49 | $218.78 |
Pacific Source Setting Facility Modifier None Typical Low $91.20 Median $144.54 Typical High $151.36 | Facility | None | $91.20 | $144.54 | $151.36 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $2,089.30 Typical High $3,162.28 | Facility | None | $141.25 | $2,089.30 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $218.78 | Professional | None | $79.43 | $138.04 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,918.31 Median $9,772.37 Typical High $11,220.18 | Facility | None | $6,918.31 | $9,772.37 | $11,220.18 |
Regence BlueShield Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $218.78 | Professional | None | $141.25 | $147.91 | $218.78 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $257.04 | Professional | None | $109.65 | $158.49 | $257.04 |
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 $50.12 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $50.12 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $19.95 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 54 · Surgery only | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.89 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 54 · Surgery only | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $10,471.29 Median $14,791.08 Typical High $16,982.44 | Facility | 50 · Both sides | $10,471.29 | $14,791.08 | $16,982.44 |
Where Oregon sits
The same service costs 11.2 times more in Tennessee than in New York. 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· 17th of 51
$145
TN $832NY $74.13
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.