How much rates vary
Facilitymedian $724 · 10th to 90th $437 to $2,512Professionalmedian $275 · 10th to 90th $117 to $1,047
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 $109.65 Median $436.52 Typical High $676.08 | Professional | None | $109.65 | $436.52 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $691.83 Typical High $1,000.00 | Facility | None | $562.34 | $691.83 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $257.04 Typical High $1,047.13 | Professional | None | $120.23 | $257.04 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $912.01 | Professional | None | $141.25 | $213.80 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $1,000.00 Typical High $7,943.28 | Facility | None | $173.78 | $1,000.00 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $524.81 Typical High $977.24 | Professional | None | $109.65 | $524.81 | $977.24 |
Pacific Source Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $831.76 | Facility | None | $467.74 | $724.44 | $831.76 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $691.83 Typical High $1,047.13 | Facility | None | $194.98 | $691.83 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $239.88 Typical High $1,047.13 | Professional | None | $79.43 | $239.88 | $1,047.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,818.38 | Facility | None | $1,737.80 | $2,187.76 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $1,096.48 | Professional | None | $151.36 | $275.42 | $1,096.48 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,630.78 | Facility | None | $354.81 | $660.69 | $3,630.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $489.78 Typical High $1,202.26 | Professional | None | $162.18 | $489.78 | $1,202.26 |
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 $60.26 Median $69.18 Typical High $323.59 | Professional | 52 · Reduced service | $60.26 | $69.18 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.18 Typical High $128.82 | Professional | 53 · Discontinued | $24.55 | $28.18 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $478.63 | Professional | 54 · Surgery only | $91.20 | $104.71 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $97.72 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.80 Typical High $64.57 | Professional | 56 · Pre-op care only | $12.30 | $13.80 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $323.59 | Professional | 52 · Reduced service | $60.26 | $60.26 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $128.82 | Professional | 53 · Discontinued | $24.55 | $24.55 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $478.63 | Professional | 54 · Surgery only | $91.20 | $91.20 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $97.72 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $64.57 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $64.57 |
Where Oregon sits
The same service costs 7.8 times more in Oklahoma 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
$646
OK $1,148NE $148
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.