How much rates vary
Facilitymedian $331 · 10th to 90th $191 to $1,380Professionalmedian $288 · 10th to 90th $162 to $457
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 $204.17 Median $229.09 Typical High $229.09 | Professional | None | $204.17 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $676.08 | Facility | None | $398.11 | $501.19 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $457.09 | Professional | None | $204.17 | $269.15 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $371.54 | Professional | None | $234.42 | $309.03 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $446.68 Typical High $7,943.28 | Facility | None | $229.09 | $446.68 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $380.19 | Professional | None | $194.98 | $229.09 | $380.19 |
Pacific Source Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $338.84 | Facility | None | $190.55 | $316.23 | $338.84 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $478.63 Typical High $707.95 | Facility | None | $269.15 | $478.63 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $269.15 Typical High $489.78 | Professional | None | $79.43 | $269.15 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,737.80 | Facility | None | $1,148.15 | $1,548.82 | $1,737.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $436.52 | Professional | None | $323.59 | $338.84 | $436.52 |
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 $208.93 Median $309.03 Typical High $524.81 | Professional | None | $208.93 | $309.03 | $524.81 |
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 $102.33 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $40.74 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $154.88 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $30.90 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $109.65 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $43.65 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 54 · Surgery only | $162.18 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $32.36 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $22.91 |
Where Oregon sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 8th of 51
$302
AK $603UT $132
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.