How much rates vary
Facilitymedian $4,266 · 10th to 90th $2,291 to $20,893Professionalmedian $1,122 · 10th to 90th $468 to $5,370
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 $446.68 Median $2,041.74 Typical High $3,162.28 | Professional | None | $446.68 | $2,041.74 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,778.28 Typical High $5,623.41 | Professional | None | $489.78 | $1,778.28 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $5,011.87 | Professional | None | $616.60 | $870.96 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $5,370.32 Typical High $8,709.64 | Facility | None | $676.08 | $5,370.32 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $2,041.74 Typical High $4,365.16 | Professional | None | $467.74 | $2,041.74 | $4,365.16 |
Pacific Source Setting Facility Modifier None Typical Low $2,511.89 Median $3,801.89 Typical High $4,265.80 | Facility | None | $2,511.89 | $3,801.89 | $4,265.80 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $3,162.28 Typical High $6,165.95 | Facility | None | $467.74 | $3,162.28 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,000.00 Typical High $5,623.41 | Professional | None | $79.43 | $1,000.00 | $5,623.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $13,803.84 Median $19,054.61 Typical High $21,877.62 | Facility | None | $13,803.84 | $19,054.61 | $21,877.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $2,398.83 Typical High $5,128.61 | Professional | None | $660.69 | $2,398.83 | $5,128.61 |
United Setting Facility Modifier None Typical Low $17,378.01 Median $21,877.62 Typical High $27,542.29 | Facility | None | $17,378.01 | $21,877.62 | $27,542.29 |
United Setting Professional Modifier None Typical Low $501.19 Median $1,819.70 Typical High $5,495.41 | Professional | None | $501.19 | $1,819.70 | $5,495.41 |
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 $223.87 Median $537.03 Typical High $1,584.89 | Professional | 52 · Reduced service | $223.87 | $537.03 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $218.78 Typical High $630.96 | Professional | 53 · Discontinued | $89.13 | $218.78 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $812.83 Typical High $2,344.23 | Professional | 54 · Surgery only | $354.81 | $812.83 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $162.18 Typical High $478.63 | Professional | 55 · Aftercare only | $67.61 | $162.18 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $109.65 Typical High $316.23 | Professional | 56 · Pre-op care only | $44.67 | $109.65 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $323.59 Typical High $1,584.89 | Professional | 52 · Reduced service | $223.87 | $323.59 | $1,584.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $128.82 Typical High $630.96 | Professional | 53 · Discontinued | $89.13 | $128.82 | $630.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $478.63 Typical High $2,344.23 | Professional | 54 · Surgery only | $338.84 | $478.63 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $95.50 Typical High $478.63 | Professional | 55 · Aftercare only | $67.61 | $95.50 | $478.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $64.57 Typical High $316.23 | Professional | 56 · Pre-op care only | $44.67 | $64.57 | $316.23 |
Where Oregon sits
The same service costs 6.9 times more in Wisconsin 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· 6th of 51
$2,512
WI $3,162HI $457
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.