How much rates vary
Facilitymedian $389 · 10th to 90th $257 to $10,471Professionalmedian $363 · 10th to 90th $191 to $550
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 $5,128.61 Median $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $281.84 | Professional | None | $190.55 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $4,570.88 Typical High $6,165.95 | Facility | None | $2,187.76 | $4,570.88 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $512.86 | Professional | None | $251.19 | $323.59 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $407.38 | Professional | None | $295.12 | $338.84 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $5,623.41 Typical High $17,378.01 | Facility | None | $398.11 | $5,623.41 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $489.78 | Professional | None | $239.88 | $281.84 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $398.11 | Facility | None | $229.09 | $363.08 | $398.11 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $4,265.80 Typical High $6,456.54 | Facility | None | $467.74 | $4,265.80 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $371.54 Typical High $549.54 | Professional | None | $79.43 | $371.54 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $11,481.54 Median $16,218.10 Typical High $18,620.87 | Facility | None | $11,481.54 | $16,218.10 | $18,620.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $562.34 | Professional | None | $354.81 | $380.19 | $562.34 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $22,908.68 | Facility | None | $1,949.84 | $3,548.13 | $22,908.68 |
United Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $645.65 | Professional | None | $295.12 | $426.58 | $645.65 |
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 $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $97.72 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $38.90 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $144.54 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $28.84 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.50 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Where Oregon sits
The same service costs 10.2 times more in Oklahoma than in Kentucky. 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· 17th of 51
$380
OK $1,950KY $191
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.