How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,862 to $41,687Professionalmedian $2,455 · 10th to 90th $1,698 to $4,074
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $23,442.29 Typical High $30,902.95 | Facility | None | $2,238.72 | $23,442.29 | $30,902.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $3,090.30 Typical High $3,630.78 | Professional | None | $1,412.54 | $3,090.30 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $1,862.09 Median $6,025.60 Typical High $8,709.64 | Facility | None | $1,862.09 | $6,025.60 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,548.82 | $1,698.24 | $1,698.24 |
Pacific Source Setting Facility Modifier None Typical Low $1,659.59 Median $2,818.38 Typical High $40,738.03 | Facility | None | $1,659.59 | $2,818.38 | $40,738.03 |
Providence Setting Facility Modifier None Typical Low $2,137.96 Median $21,877.62 Typical High $30,902.95 | Facility | None | $2,137.96 | $21,877.62 | $30,902.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $2,754.23 | Professional | None | $79.43 | $79.43 | $2,754.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $48,977.88 Median $64,565.42 Typical High $87,096.36 | Facility | None | $48,977.88 | $64,565.42 | $87,096.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,630.78 | Professional | None | $2,398.83 | $2,511.89 | $3,630.78 |
United Setting Facility Modifier None Typical Low $3,548.13 Median $12,882.50 Typical High $63,095.73 | Facility | None | $3,548.13 | $12,882.50 | $63,095.73 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,754.23 | $4,570.88 |
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 $676.08 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $338.84 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,174.90 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $234.42 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $169.82 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $72,443.60 Median $104,712.85 Typical High $138,038.43 | Facility | 50 · Both sides | $72,443.60 | $104,712.85 | $138,038.43 |
Where Oregon sits
The same service costs 6.9 times more in Arkansas 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· 12th of 51
$2,818
AR $8,318KY $1,202
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.