How much rates vary
Facilitymedian $257 · 10th to 90th $166 to $1,349Professionalmedian $162 · 10th to 90th $79 to $372
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 $128.82 Median $4,677.35 Typical High $7,943.28 | Facility | None | $128.82 | $4,677.35 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $134.90 Typical High $275.42 | Professional | None | $53.70 | $134.90 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $234.42 Typical High $870.96 | Facility | None | $186.21 | $234.42 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $169.82 Typical High $426.58 | Professional | None | $81.28 | $169.82 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $371.54 | Professional | None | $87.10 | $123.03 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $354.81 Typical High $7,943.28 | Facility | None | $114.82 | $354.81 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $154.88 Typical High $323.59 | Professional | None | $60.26 | $154.88 | $323.59 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $251.19 Typical High $316.23 | Facility | None | $165.96 | $251.19 | $316.23 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $234.42 Typical High $1,023.29 | Facility | None | $128.82 | $234.42 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $426.58 | Professional | None | $79.43 | $165.96 | $426.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $977.24 Median $1,659.59 Typical High $2,511.89 | Facility | None | $977.24 | $1,659.59 | $2,511.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $316.23 | Professional | None | $107.15 | $190.55 | $316.23 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,630.78 | Facility | None | $354.81 | $660.69 | $3,630.78 |
United Setting Professional Modifier None Typical Low $91.20 Median $194.98 Typical High $416.87 | Professional | None | $91.20 | $194.98 | $416.87 |
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 $39.81 Median $39.81 Typical High $114.82 | Professional | 52 · Reduced service | $39.81 | $39.81 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $45.71 | Professional | 53 · Discontinued | $15.85 | $15.85 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $173.78 | Professional | 54 · Surgery only | $60.26 | $60.26 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $34.67 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $22.91 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $39.81 Typical High $114.82 | Professional | 52 · Reduced service | $39.81 | $39.81 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $45.71 | Professional | 53 · Discontinued | $15.85 | $15.85 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $173.78 | Professional | 54 · Surgery only | $60.26 | $60.26 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $34.67 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $22.91 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $22.91 |
Where Oregon sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 4th of 51
$224
AK $282MT $107
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.