How much rates vary
Facilitymedian $1,413 · 10th to 90th $224 to $5,012Professionalmedian $380 · 10th to 90th $224 to $676
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 $223.87 Median $223.87 Typical High $316.23 | Professional | None | $223.87 | $223.87 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,818.38 Typical High $3,801.89 | Facility | None | $1,023.29 | $2,818.38 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $660.69 | Professional | None | $467.74 | $537.03 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $5,011.87 Typical High $7,943.28 | Facility | None | $245.47 | $5,011.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Pacific Source Setting Facility Modifier None Typical Low $194.98 Median $1,148.15 Typical High $1,949.84 | Facility | None | $194.98 | $1,148.15 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $2,630.27 Typical High $3,630.78 | Facility | None | $549.54 | $2,630.27 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $234.42 Typical High $457.09 | Professional | None | $79.43 | $234.42 | $457.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $15,488.17 | Facility | None | $5,128.61 | $7,244.36 | $15,488.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $660.69 | Professional | None | $354.81 | $380.19 | $660.69 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $870.96 | Professional | None | $302.00 | $436.52 | $870.96 |
10 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 $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
Where Oregon sits
The same service costs 19.5 times more in Texas than in New York. 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· 8th of 51
$1,047
TX $1,778NY $91.20
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.