How much rates vary
Facilitymedian $4,677 · 10th to 90th $741 to $10,233Professionalmedian $1,288 · 10th to 90th $832 to $2,239
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | None | $691.83 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $7,585.78 Typical High $10,232.93 | Facility | None | $1,023.29 | $7,585.78 | $10,232.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,698.24 Typical High $1,995.26 | Professional | None | $776.25 | $1,698.24 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $7,943.28 Typical High $17,378.01 | Facility | None | $954.99 | $7,943.28 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | None | $794.33 | $870.96 | $870.96 |
Pacific Source Setting Facility Modifier None Typical Low $524.81 Median $4,168.69 Typical High $6,309.57 | Facility | None | $524.81 | $4,168.69 | $6,309.57 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $7,244.36 Typical High $10,000.00 | Facility | None | $870.96 | $7,244.36 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,621.81 Typical High $1,659.59 | Professional | None | $79.43 | $1,621.81 | $1,659.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $16,218.10 Typical High $20,417.38 | Facility | None | $11,481.54 | $16,218.10 | $20,417.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,348.96 | $1,949.84 |
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 $1,071.52 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,412.54 | $2,630.27 |
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 $346.74 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $87.10 |
Where Oregon sits
The same service costs 5.1 times more in Texas than in Delaware. 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
$2,188
TX $3,981DE $776
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.