How much rates vary
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 $165.96 Median $346.74 Typical High $512.86 | Professional | None | $165.96 | $346.74 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $2,818.38 | Facility | None | $1,737.80 | $2,511.89 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $426.58 Typical High $831.76 | Professional | None | $208.93 | $426.58 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $758.58 | Professional | None | $229.09 | $338.84 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $741.31 Typical High $7,943.28 | Facility | None | $251.19 | $741.31 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $426.58 Typical High $776.25 | Professional | None | $173.78 | $426.58 | $776.25 |
Pacific Source Setting Facility Modifier None Typical Low $371.54 Median $575.44 Typical High $691.83 | Facility | None | $371.54 | $575.44 | $691.83 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $724.44 Typical High $2,630.27 | Facility | None | $257.04 | $724.44 | $2,630.27 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $371.54 Typical High $831.76 | Professional | None | $79.43 | $371.54 | $831.76 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $891.25 | Professional | None | $251.19 | $457.09 | $891.25 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $245.47 Median $478.63 Typical High $912.01 | Professional | None | $245.47 | $478.63 | $912.01 |
6 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 54 · Surgery only Typical Low $131.83 Median $199.53 Typical High $331.13 | Professional | 54 · Surgery only | $131.83 | $199.53 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $39.81 Typical High $66.07 | Professional | 55 · Aftercare only | $26.30 | $39.81 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $44.67 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $44.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $331.13 | Professional | 54 · Surgery only | $131.83 | $131.83 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $66.07 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $44.67 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $44.67 |
Where Oregon sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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· 5th of 51
$490
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.