How much rates vary
Facilitymedian $155 · 10th to 90th $91 to $575Professionalmedian $123 · 10th to 90th $72 to $219
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $147.91 | Professional | None | $52.48 | $83.18 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $223.87 | Professional | None | $74.13 | $125.89 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $190.55 | Professional | None | $83.18 | $125.89 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $7,943.28 | Facility | None | $104.71 | $173.78 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $218.78 | Professional | None | $64.57 | $117.49 | $218.78 |
Pacific Source Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $213.80 | Facility | None | $91.20 | $151.36 | $213.80 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $173.78 Typical High $645.65 | Facility | None | $66.07 | $173.78 | $645.65 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $229.09 | Professional | None | $74.13 | $131.83 | $229.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $794.33 | Facility | None | $524.81 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $208.93 | Professional | None | $97.72 | $151.36 | $208.93 |
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 $85.11 Median $141.25 Typical High $263.03 | Professional | None | $85.11 | $141.25 | $263.03 |
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 $36.31 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $23.44 | Professional | 53 · Discontinued | $14.45 | $14.45 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $54.95 Typical High $87.10 | Professional | 54 · Surgery only | $54.95 | $54.95 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $17.38 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $11.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $36.31 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $36.31 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $23.44 | Professional | 53 · Discontinued | $14.45 | $14.45 | $23.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $54.95 Typical High $87.10 | Professional | 54 · Surgery only | $54.95 | $54.95 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $17.38 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $11.75 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $776.25 Median $1,047.13 Typical High $1,174.90 | Facility | 50 · Both sides | $776.25 | $1,047.13 | $1,174.90 |
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· 7th of 51
$138
WI $229KY $72.44
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.