How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,698 to $4,898Professionalmedian $490 · 10th to 90th $195 to $4,786
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 $131.83 Median $1,819.70 Typical High $2,754.23 | Professional | None | $131.83 | $1,819.70 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $831.76 Typical High $1,071.52 | Facility | None | $50.12 | $831.76 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $4,897.79 | Professional | None | $208.93 | $467.74 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $4,168.69 | Professional | None | $251.19 | $371.54 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $4,786.30 Typical High $7,943.28 | Facility | None | $281.84 | $4,786.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $1,819.70 Typical High $4,073.80 | Professional | None | $131.83 | $1,819.70 | $4,073.80 |
Pacific Source Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $3,801.89 | Facility | None | $1,905.46 | $3,162.28 | $3,801.89 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $1,000.00 Typical High $4,897.79 | Facility | None | $199.53 | $1,000.00 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $4,786.30 | Professional | None | $79.43 | $426.58 | $4,786.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $5,011.87 | Professional | None | $281.84 | $501.19 | $5,011.87 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $25,118.86 | Facility | None | $2,691.53 | $4,677.35 | $25,118.86 |
United Setting Professional Modifier None Typical Low $275.42 Median $2,137.96 Typical High $5,128.61 | Professional | None | $275.42 | $2,137.96 | $5,128.61 |
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 $97.72 Median $114.82 Typical High $1,380.38 | Professional | 52 · Reduced service | $97.72 | $114.82 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $46.77 Typical High $549.54 | Professional | 53 · Discontinued | $38.90 | $46.77 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $173.78 Typical High $2,089.30 | Professional | 54 · Surgery only | $147.91 | $173.78 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $34.67 Typical High $416.87 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.91 Typical High $275.42 | Professional | 56 · Pre-op care only | $19.50 | $22.91 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $97.72 Typical High $1,380.38 | Professional | 52 · Reduced service | $97.72 | $97.72 | $1,380.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $549.54 | Professional | 53 · Discontinued | $38.90 | $38.90 | $549.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $2,089.30 | Professional | 54 · Surgery only | $147.91 | $147.91 | $2,089.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $416.87 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $416.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $275.42 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $275.42 |
Where Oregon sits
The same service costs 11.2 times more in Oklahoma 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· 2nd of 51
$2,818
OK $2,818HI $251
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.