How much rates vary
Facilitymedian $398 · 10th to 90th $275 to $11,220Professionalmedian $380 · 10th to 90th $204 to $575
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | None | $275.42 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $6,606.93 Typical High $8,912.51 | Facility | None | $2,187.76 | $6,606.93 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $537.03 | Professional | None | $269.15 | $346.74 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $457.09 | Professional | None | $331.13 | $389.05 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $7,943.28 Typical High $17,378.01 | Facility | None | $338.84 | $7,943.28 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $575.44 | Professional | None | $295.12 | $309.03 | $575.44 |
Pacific Source Setting Facility Modifier None Typical Low $239.88 Median $380.19 Typical High $416.87 | Facility | None | $239.88 | $380.19 | $416.87 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $6,309.57 Typical High $8,912.51 | Facility | None | $501.19 | $6,309.57 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $380.19 Typical High $575.44 | Professional | None | $79.43 | $380.19 | $575.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $16,218.10 Median $22,908.68 Typical High $27,542.29 | Facility | None | $16,218.10 | $22,908.68 | $27,542.29 |
Regence BlueShield Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $588.84 | Professional | None | $371.54 | $389.05 | $588.84 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $676.08 | Professional | None | $316.23 | $457.09 | $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 $134.90 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $54.95 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $40.74 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $27.54 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $30.90 |
Where Oregon sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 16th of 51
$398
TN $1,413NY $204
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.