How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,514 to $5,129Professionalmedian $813 · 10th to 90th $309 to $3,467
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $1,096.48 Typical High $1,905.46 | Professional | None | $223.87 | $1,096.48 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $1,318.26 Typical High $3,630.78 | Professional | None | $338.84 | $1,318.26 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $4,073.80 | Professional | None | $436.52 | $630.96 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $3,090.30 Typical High $7,943.28 | Facility | None | $446.68 | $3,090.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $1,096.48 Typical High $2,884.03 | Professional | None | $229.09 | $1,096.48 | $2,884.03 |
Pacific Source Setting Facility Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $2,511.89 | Facility | None | $1,513.56 | $2,454.71 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $2,570.40 Typical High $3,715.35 | Facility | None | $338.84 | $2,570.40 | $3,715.35 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $724.44 Typical High $3,548.13 | Professional | None | $218.78 | $724.44 | $3,548.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $467.74 Median $1,621.81 Typical High $3,235.94 | Professional | None | $467.74 | $1,621.81 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $4,897.79 Typical High $6,165.95 | Facility | None | $1,122.02 | $4,897.79 | $6,165.95 |
United Setting Professional Modifier None Typical Low $323.59 Median $1,096.48 Typical High $3,467.37 | Professional | None | $323.59 | $1,096.48 | $3,467.37 |
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 $154.88 Median $354.81 Typical High $954.99 | Professional | 52 · Reduced service | $154.88 | $354.81 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $141.25 Typical High $380.19 | Professional | 53 · Discontinued | $61.66 | $141.25 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $537.03 Typical High $1,445.44 | Professional | 54 · Surgery only | $234.42 | $537.03 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $107.15 Typical High $288.40 | Professional | 55 · Aftercare only | $46.77 | $107.15 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $70.79 Typical High $190.55 | Professional | 56 · Pre-op care only | $30.90 | $70.79 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $218.78 Typical High $954.99 | Professional | 52 · Reduced service | $154.88 | $218.78 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $87.10 Typical High $380.19 | Professional | 53 · Discontinued | $61.66 | $87.10 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $1,445.44 | Professional | 54 · Surgery only | $234.42 | $331.13 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $66.07 Typical High $288.40 | Professional | 55 · Aftercare only | $46.77 | $66.07 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $43.65 Typical High $190.55 | Professional | 56 · Pre-op care only | $30.90 | $43.65 | $190.55 |
Where Oregon sits
The same service costs 6.5 times more in Washington 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· 12th of 51
$1,349
WA $2,138MD $331
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.