How much rates vary
Facilitymedian $1,230 · 10th to 90th $759 to $4,786Professionalmedian $525 · 10th to 90th $195 to $1,778
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 $275.42 Median $4,786.30 Typical High $7,943.28 | Facility | None | $275.42 | $4,786.30 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $524.81 Typical High $1,047.13 | Professional | None | $144.54 | $524.81 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,445.44 | Facility | None | $758.58 | $1,071.52 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $575.44 Typical High $1,905.46 | Professional | None | $234.42 | $575.44 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $1,819.70 | Professional | None | $288.40 | $426.58 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $1,380.38 Typical High $6,606.93 | Facility | None | $275.42 | $1,380.38 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $524.81 Typical High $1,348.96 | Professional | None | $151.36 | $524.81 | $1,348.96 |
Pacific Source Setting Facility Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,380.38 | Facility | None | $794.33 | $1,230.27 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $1,071.52 Typical High $1,548.82 | Facility | None | $346.74 | $1,071.52 | $1,548.82 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $489.78 Typical High $1,949.84 | Professional | None | $229.09 | $489.78 | $1,949.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,041.74 Median $5,495.41 Typical High $7,244.36 | Facility | None | $2,041.74 | $5,495.41 | $7,244.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $309.03 Median $851.14 Typical High $1,698.24 | Professional | None | $309.03 | $851.14 | $1,698.24 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $6,918.31 | Facility | None | $602.56 | $1,000.00 | $6,918.31 |
United Setting Professional Modifier None Typical Low $218.78 Median $645.65 Typical High $1,819.70 | Professional | None | $218.78 | $645.65 | $1,819.70 |
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 $109.65 Median $257.04 Typical High $524.81 | Professional | 52 · Reduced service | $109.65 | $257.04 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $102.33 Typical High $208.93 | Professional | 53 · Discontinued | $44.67 | $102.33 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $380.19 Typical High $776.25 | Professional | 54 · Surgery only | $165.96 | $380.19 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $75.86 Typical High $154.88 | Professional | 55 · Aftercare only | $33.11 | $75.86 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $51.29 Typical High $104.71 | Professional | 56 · Pre-op care only | $22.39 | $51.29 | $104.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $151.36 Typical High $524.81 | Professional | 52 · Reduced service | $109.65 | $151.36 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $208.93 | Professional | 53 · Discontinued | $44.67 | $60.26 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $229.09 Typical High $776.25 | Professional | 54 · Surgery only | $165.96 | $229.09 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $45.71 Typical High $154.88 | Professional | 55 · Aftercare only | $33.11 | $45.71 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.20 Typical High $104.71 | Professional | 56 · Pre-op care only | $22.39 | $30.20 | $104.71 |
Where Oregon sits
The same service costs 5.2 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· 5th of 51
$851
WI $1,148HI $219
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.