How much rates vary
Facilitymedian $2,455 · 10th to 90th $575 to $5,623Professionalmedian $741 · 10th to 90th $269 to $3,162
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 $5,623.41 Typical High $8,709.64 | Facility | None | $3,890.45 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $1,000.00 Typical High $1,949.84 | Professional | None | $234.42 | $1,000.00 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $1,071.52 Typical High $3,388.44 | Professional | None | $323.59 | $1,071.52 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $3,162.28 | Professional | None | $416.87 | $588.84 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $2,754.23 Typical High $8,709.64 | Facility | None | $436.52 | $2,754.23 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $741.31 Typical High $2,398.83 | Professional | None | $245.47 | $741.31 | $2,398.83 |
Pacific Source Setting Facility Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,630.27 | Facility | None | $1,513.56 | $2,344.23 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $1,995.26 Typical High $3,162.28 | Facility | None | $446.68 | $1,995.26 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $676.08 Typical High $3,388.44 | Professional | None | $79.43 | $676.08 | $3,388.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $1,479.11 Typical High $3,090.30 | Professional | None | $436.52 | $1,479.11 | $3,090.30 |
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 $302.00 Median $1,047.13 Typical High $3,311.31 | Professional | None | $302.00 | $1,047.13 | $3,311.31 |
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 $151.36 Median $354.81 Typical High $977.24 | Professional | 52 · Reduced service | $151.36 | $354.81 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $141.25 Typical High $389.05 | Professional | 53 · Discontinued | $60.26 | $141.25 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $537.03 Typical High $1,445.44 | Professional | 54 · Surgery only | $223.87 | $537.03 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $107.15 Typical High $288.40 | Professional | 55 · Aftercare only | $45.71 | $107.15 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $70.79 Typical High $194.98 | Professional | 56 · Pre-op care only | $30.20 | $70.79 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $208.93 Typical High $977.24 | Professional | 52 · Reduced service | $151.36 | $208.93 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $85.11 Typical High $389.05 | Professional | 53 · Discontinued | $60.26 | $85.11 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $316.23 Typical High $1,445.44 | Professional | 54 · Surgery only | $223.87 | $316.23 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $63.10 Typical High $288.40 | Professional | 55 · Aftercare only | $45.71 | $63.10 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $41.69 Typical High $194.98 | Professional | 56 · Pre-op care only | $30.20 | $41.69 | $194.98 |
Where Oregon sits
The same service costs 5.8 times more in Washington than in Hawaii. 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
$1,318
WA $1,820HI $316
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.