How much rates vary
Facilitymedian $214 · 10th to 90th $141 to $1,862Professionalmedian $162 · 10th to 90th $78 to $269
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 $74.13 Median $114.82 Typical High $162.18 | Professional | None | $74.13 | $114.82 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $660.69 | Facility | None | $141.25 | $177.83 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $275.42 | Professional | None | $77.62 | $147.91 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $309.03 | Professional | None | $102.33 | $144.54 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $275.42 Typical High $6,606.93 | Facility | None | $107.15 | $275.42 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $162.18 Typical High $251.19 | Professional | None | $74.13 | $162.18 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $251.19 | Facility | None | $138.04 | $213.80 | $251.19 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $660.69 | Facility | None | $128.82 | $194.98 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $281.84 | Professional | None | $79.43 | $162.18 | $281.84 |
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 $102.33 Median $177.83 Typical High $223.87 | Professional | None | $102.33 | $177.83 | $223.87 |
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 $85.11 Median $162.18 Typical High $295.12 | Professional | None | $85.11 | $162.18 | $295.12 |
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 $37.15 Median $51.29 Typical High $81.28 | Professional | 52 · Reduced service | $37.15 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.42 Typical High $32.36 | Professional | 53 · Discontinued | $14.79 | $20.42 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $77.62 Typical High $120.23 | Professional | 54 · Surgery only | $56.23 | $77.62 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $15.49 Typical High $23.99 | Professional | 55 · Aftercare only | $11.22 | $15.49 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.23 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.41 | $10.23 | $16.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $45.71 Typical High $81.28 | Professional | 52 · Reduced service | $37.15 | $45.71 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $32.36 | Professional | 53 · Discontinued | $14.79 | $18.62 | $32.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $69.18 Typical High $120.23 | Professional | 54 · Surgery only | $56.23 | $69.18 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $23.99 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $16.22 |
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 Alaska than in Virginia. 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
$166
AK $263VA $81.28
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.