How much rates vary
Facilitymedian $186 · 10th to 90th $105 to $724Professionalmedian $151 · 10th to 90th $79 to $275
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 $91.20 Median $4,786.30 Typical High $7,943.28 | Facility | None | $91.20 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $162.18 | Professional | None | $74.13 | $107.15 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $102.33 Typical High $141.25 | Facility | None | $79.43 | $102.33 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $281.84 | Professional | None | $89.13 | $151.36 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $234.42 | Professional | None | $102.33 | $158.49 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $263.03 Typical High $6,606.93 | Facility | None | $104.71 | $263.03 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $281.84 | Professional | None | $77.62 | $147.91 | $281.84 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $186.21 Typical High $208.93 | Facility | None | $112.20 | $186.21 | $208.93 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $263.03 | Facility | None | $79.43 | $109.65 | $263.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $275.42 | Professional | None | $79.43 | $165.96 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $794.33 | Facility | None | $489.78 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $275.42 | Professional | None | $120.23 | $194.98 | $275.42 |
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 $107.15 Median $173.78 Typical High $288.40 | Professional | None | $107.15 | $173.78 | $288.40 |
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 $36.31 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $36.31 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $14.79 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $54.95 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.41 | $10.00 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $36.31 | $50.12 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $23.99 Typical High $57.54 | Professional | 53 · Discontinued | $14.79 | $23.99 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $66.07 Typical High $91.20 | Professional | 54 · Surgery only | $54.95 | $66.07 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.18 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $13.18 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.71 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.41 | $8.71 | $12.02 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $83.18 Median $144.54 Typical High $288.40 | Professional | 59 · Distinct service | $83.18 | $144.54 | $288.40 |
Where Oregon sits
The same service costs 3.0 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
$166
WI $282KY $93.33
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.