How much rates vary
Facilitymedian $275 · 10th to 90th $162 to $2,239Professionalmedian $186 · 10th to 90th $87 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 $107.15 Median $4,786.30 Typical High $7,943.28 | Facility | None | $107.15 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $229.09 | Professional | None | $74.13 | $120.23 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $660.69 | Facility | None | $173.78 | $218.78 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $426.58 | Professional | None | $109.65 | $204.17 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $371.54 | Professional | None | $128.82 | $194.98 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $269.15 Typical High $6,606.93 | Facility | None | $107.15 | $269.15 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $416.87 | Professional | None | $87.10 | $186.21 | $416.87 |
Pacific Source Setting Facility Modifier None Typical Low $151.36 Median $251.19 Typical High $309.03 | Facility | None | $151.36 | $251.19 | $309.03 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $707.95 | Facility | None | $158.49 | $218.78 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $416.87 | Professional | None | $79.43 | $194.98 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $3,235.94 | Facility | None | $1,905.46 | $2,691.53 | $3,235.94 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $416.87 | Professional | None | $144.54 | $245.47 | $416.87 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $125.89 Median $223.87 Typical High $436.52 | Professional | None | $125.89 | $223.87 | $436.52 |
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 $43.65 Median $48.98 Typical High $93.33 | Professional | 52 · Reduced service | $43.65 | $48.98 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.50 Typical High $37.15 | Professional | 53 · Discontinued | $17.38 | $19.50 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $74.13 Typical High $141.25 | Professional | 54 · Surgery only | $64.57 | $74.13 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.79 Typical High $28.18 | Professional | 55 · Aftercare only | $12.88 | $14.79 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $18.62 | Professional | 56 · Pre-op care only | $8.71 | $9.77 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $93.33 | Professional | 52 · Reduced service | $43.65 | $43.65 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $37.15 | Professional | 53 · Discontinued | $17.38 | $17.38 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $141.25 | Professional | 54 · Surgery only | $64.57 | $64.57 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $28.18 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $18.62 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $18.62 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $74.13 Median $104.71 Typical High $398.11 | Professional | 59 · Distinct service | $74.13 | $104.71 | $398.11 |
Where Oregon sits
The same service costs 3.3 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
$224
WI $372KY $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.