How much rates vary
Facilitymedian $501 · 10th to 90th $251 to $692Professionalmedian $417 · 10th to 90th $251 to $692
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 $251.19 Median $251.19 Typical High $416.87 | Professional | None | $251.19 | $251.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $416.87 | Facility | None | $169.82 | $302.00 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $724.44 | Professional | None | $269.15 | $457.09 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $851.14 | Professional | None | $338.84 | $489.78 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $7,943.28 | Facility | None | $331.13 | $489.78 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $630.96 | Professional | None | $251.19 | $398.11 | $630.96 |
Pacific Source Setting Facility Modifier None Typical Low $316.23 Median $512.86 Typical High $602.56 | Facility | None | $316.23 | $512.86 | $602.56 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $331.13 Typical High $741.31 | Facility | None | $251.19 | $331.13 | $741.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $724.44 | Professional | None | $79.43 | $426.58 | $724.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $691.83 Median $933.25 Typical High $1,047.13 | Facility | None | $691.83 | $933.25 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $616.60 | Professional | None | $346.74 | $549.54 | $616.60 |
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 $263.03 Median $436.52 Typical High $776.25 | Professional | None | $263.03 | $436.52 | $776.25 |
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 $208.93 | Professional | 52 · Reduced service | $125.89 | $125.89 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | 53 · Discontinued | $50.12 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | 54 · Surgery only | $186.21 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $61.66 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $41.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $125.89 Typical High $208.93 | Professional | 52 · Reduced service | $125.89 | $125.89 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | 53 · Discontinued | $50.12 | $50.12 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | 54 · Surgery only | $186.21 | $186.21 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $61.66 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $41.69 |
Where Oregon sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$417
AK $741KY $186
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.