How much rates vary
Facilitymedian $347 · 10th to 90th $200 to $5,129Professionalmedian $204 · 10th to 90th $91 to $447
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 $77.62 Median $158.49 Typical High $263.03 | Professional | None | $77.62 | $158.49 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $213.80 Typical High $467.74 | Professional | None | $95.50 | $213.80 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $436.52 | Professional | None | $120.23 | $177.83 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $501.19 Typical High $7,943.28 | Facility | None | $131.83 | $501.19 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $199.53 Typical High $380.19 | Professional | None | $77.62 | $199.53 | $380.19 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $380.19 | Facility | None | $204.17 | $331.13 | $380.19 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $275.42 Typical High $501.19 | Facility | None | $93.33 | $275.42 | $501.19 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $204.17 Typical High $478.63 | Professional | None | $89.13 | $204.17 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $416.87 | Professional | None | $131.83 | $223.87 | $416.87 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $4,897.79 Typical High $6,165.95 | Facility | None | $1,122.02 | $4,897.79 | $6,165.95 |
United Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $457.09 | Professional | None | $107.15 | $204.17 | $457.09 |
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 $45.71 Median $63.10 Typical High $125.89 | Professional | 52 · Reduced service | $45.71 | $63.10 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.12 Typical High $50.12 | Professional | 53 · Discontinued | $18.62 | $25.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $95.50 Typical High $190.55 | Professional | 54 · Surgery only | $69.18 | $95.50 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $38.02 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $25.12 | Professional | 56 · Pre-op care only | $9.12 | $12.59 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $63.10 Typical High $125.89 | Professional | 52 · Reduced service | $45.71 | $63.10 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.12 Typical High $50.12 | Professional | 53 · Discontinued | $18.62 | $25.12 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $95.50 Typical High $190.55 | Professional | 54 · Surgery only | $69.18 | $95.50 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.05 Typical High $38.02 | Professional | 55 · Aftercare only | $13.80 | $19.05 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.59 Typical High $25.12 | Professional | 56 · Pre-op care only | $9.12 | $12.59 | $25.12 |
Where Oregon sits
The same service costs 2.7 times more in Wisconsin 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· 9th of 51
$219
WI $316UT $117
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.