How much rates vary
Facilitymedian $224 · 10th to 90th $135 to $933Professionalmedian $178 · 10th to 90th $102 to $316
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 $147.91 Median $5,128.61 Typical High $7,943.28 | Facility | None | $147.91 | $5,128.61 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $173.78 | Professional | None | $87.10 | $120.23 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $204.17 | Facility | None | $95.50 | $144.54 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $331.13 | Professional | None | $123.03 | $199.53 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $302.00 | Professional | None | $147.91 | $208.93 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $229.09 Typical High $3,630.78 | Facility | None | $147.91 | $229.09 | $3,630.78 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $251.19 | Professional | None | $93.33 | $151.36 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $239.88 | Facility | None | $134.90 | $223.87 | $239.88 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $281.84 | Facility | None | $112.20 | $158.49 | $281.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $323.59 | Professional | None | $79.43 | $199.53 | $323.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $2,818.38 | Facility | None | $1,819.70 | $2,454.71 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $323.59 | Professional | None | $162.18 | $229.09 | $323.59 |
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 $141.25 Median $218.78 Typical High $354.81 | Professional | None | $141.25 | $218.78 | $354.81 |
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 $58.88 Median $58.88 Typical High $87.10 | Professional | 52 · Reduced service | $58.88 | $58.88 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $34.67 | Professional | 53 · Discontinued | $23.99 | $23.99 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | 54 · Surgery only | $89.13 | $89.13 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $26.30 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $17.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $87.10 | Professional | 52 · Reduced service | $58.88 | $58.88 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $34.67 | Professional | 53 · Discontinued | $23.99 | $23.99 | $34.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | 54 · Surgery only | $89.13 | $89.13 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $26.30 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $17.38 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $2,754.23 Median $3,630.78 Typical High $4,168.69 | Facility | 50 · Both sides | $2,754.23 | $3,630.78 | $4,168.69 |
Where Oregon sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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
$200
WI $363TX $112
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.