How much rates vary
Facilitymedian $490 · 10th to 90th $275 to $1,259Professionalmedian $363 · 10th to 90th $191 to $741
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $436.52 | Professional | None | $186.21 | $229.09 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $446.68 Typical High $891.25 | Facility | None | $354.81 | $446.68 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $758.58 | Professional | None | $190.55 | $363.08 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $676.08 | Professional | None | $223.87 | $346.74 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $616.60 Typical High $7,943.28 | Facility | None | $281.84 | $616.60 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $537.03 | Professional | None | $194.98 | $354.81 | $537.03 |
Pacific Source Setting Facility Modifier None Typical Low $316.23 Median $489.78 Typical High $549.54 | Facility | None | $316.23 | $489.78 | $549.54 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $912.01 | Facility | None | $316.23 | $446.68 | $912.01 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $741.31 | Professional | None | $79.43 | $354.81 | $741.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,698.24 | Facility | None | $1,122.02 | $1,412.54 | $1,698.24 |
Regence BlueShield Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $741.31 | Professional | None | $257.04 | $436.52 | $741.31 |
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 $223.87 Median $426.58 Typical High $776.25 | Professional | None | $223.87 | $426.58 | $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 $97.72 Median $97.72 Typical High $218.78 | Professional | 52 · Reduced service | $97.72 | $97.72 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $87.10 | Professional | 53 · Discontinued | $38.90 | $38.90 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $323.59 | Professional | 54 · Surgery only | $147.91 | $147.91 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $64.57 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $43.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $97.72 Typical High $218.78 | Professional | 52 · Reduced service | $97.72 | $97.72 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $87.10 | Professional | 53 · Discontinued | $38.90 | $38.90 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $323.59 | Professional | 54 · Surgery only | $147.91 | $147.91 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $64.57 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $43.65 |
Where Oregon sits
The same service costs 3.1 times more in Wisconsin 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· 4th of 51
$437
WI $676KY $219
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.