How much rates vary
Facilitymedian $257 · 10th to 90th $155 to $977Professionalmedian $224 · 10th to 90th $117 to $407
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 $144.54 Median $4,786.30 Typical High $7,943.28 | Facility | None | $144.54 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $208.93 | Professional | None | $97.72 | $134.90 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $660.69 | Facility | None | $131.83 | $165.96 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $426.58 | Professional | None | $141.25 | $234.42 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $363.08 | Professional | None | $165.96 | $239.88 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $257.04 Typical High $6,606.93 | Facility | None | $144.54 | $257.04 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $426.58 | Professional | None | $117.49 | $177.83 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $257.04 Typical High $302.00 | Facility | None | $165.96 | $257.04 | $302.00 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $190.55 Typical High $660.69 | Facility | None | $131.83 | $190.55 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $407.38 | Professional | None | $79.43 | $234.42 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,258.93 | Facility | None | $812.83 | $1,122.02 | $1,258.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $407.38 | Professional | None | $194.98 | $295.12 | $407.38 |
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 $165.96 Median $263.03 Typical High $436.52 | Professional | None | $165.96 | $263.03 | $436.52 |
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 $58.88 Median $67.61 Typical High $89.13 | Professional | 52 · Reduced service | $58.88 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $23.44 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $134.90 | Professional | 54 · Surgery only | $87.10 | $102.33 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $26.92 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.75 | $13.49 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $89.13 | Professional | 52 · Reduced service | $58.88 | $58.88 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $35.48 | Professional | 53 · Discontinued | $23.44 | $23.44 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $134.90 | Professional | 54 · Surgery only | $87.10 | $87.10 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $26.92 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $17.78 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $17.78 |
Where Oregon sits
The same service costs 3.2 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
$240
WI $417KY $129
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.