How much rates vary
Facilitymedian $166 · 10th to 90th $93 to $4,074Professionalmedian $363 · 10th to 90th $251 to $550
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 $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $2,137.96 | Facility | None | $660.69 | $1,000.00 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $501.19 | Professional | None | $263.03 | $323.59 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $501.19 | Professional | None | $363.08 | $416.87 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $5,011.87 Typical High $7,943.28 | Facility | None | $275.42 | $5,011.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $93.33 Median $158.49 Typical High $169.82 | Facility | None | $93.33 | $158.49 | $169.82 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $645.65 Typical High $1,071.52 | Facility | None | $281.84 | $645.65 | $1,071.52 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $501.19 | Professional | None | $186.21 | $302.00 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $549.54 | Professional | None | $354.81 | $371.54 | $549.54 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $676.08 | Professional | None | $269.15 | $478.63 | $676.08 |
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 $125.89 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $125.89 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.12 |
Where Oregon sits
The same service costs 7.2 times more in Oklahoma 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· 32nd of 51
$263
OK $1,000VA $138
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.