How much rates vary
Facilitymedian $275 · 10th to 90th $117 to $427Professionalmedian $166 · 10th to 90th $79 to $347
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 $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $223.87 | Professional | None | $63.10 | $114.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $407.38 | Professional | None | $102.33 | $199.53 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $363.08 | Professional | None | $109.65 | $144.54 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $223.87 Typical High $7,943.28 | Facility | None | $112.20 | $223.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $269.15 | Professional | None | $74.13 | $138.04 | $269.15 |
Pacific Source Setting Facility Modifier None Typical Low $114.82 Median $263.03 Typical High $309.03 | Facility | None | $114.82 | $263.03 | $309.03 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $204.17 Typical High $389.05 | Facility | None | $83.18 | $204.17 | $389.05 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $380.19 | Professional | None | $79.43 | $177.83 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,621.81 | Facility | None | $954.99 | $1,348.96 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $309.03 | Professional | None | $134.90 | $229.09 | $309.03 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $407.38 | Professional | None | $112.20 | $213.80 | $407.38 |
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 $48.98 Median $48.98 Typical High $112.20 | Professional | 52 · Reduced service | $48.98 | $48.98 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $45.71 | Professional | 53 · Discontinued | $19.95 | $19.95 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $169.82 | Professional | 54 · Surgery only | $74.13 | $74.13 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $33.88 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $22.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $48.98 Typical High $112.20 | Professional | 52 · Reduced service | $48.98 | $48.98 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $45.71 | Professional | 53 · Discontinued | $19.95 | $19.95 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $169.82 | Professional | 54 · Surgery only | $74.13 | $74.13 | $169.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $33.88 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $22.39 |
Where Oregon sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$214
AK $355MD $100
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.