How much rates vary
Facilitymedian $372 · 10th to 90th $224 to $2,951Professionalmedian $245 · 10th to 90th $115 to $468
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 $123.03 Median $190.55 Typical High $309.03 | Professional | None | $123.03 | $190.55 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $1,000.00 | Facility | None | $229.09 | $288.40 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $245.47 Typical High $478.63 | Professional | None | $114.82 | $245.47 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $478.63 | Professional | None | $128.82 | $194.98 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $2,089.30 Typical High $7,943.28 | Facility | None | $173.78 | $2,089.30 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $398.11 | Professional | None | $123.03 | $257.04 | $398.11 |
Pacific Source Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $380.19 | Facility | None | $223.87 | $363.08 | $380.19 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $295.12 Typical High $1,047.13 | Facility | None | $158.49 | $295.12 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $239.88 Typical High $512.86 | Professional | None | $83.18 | $239.88 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,344.23 Median $3,235.94 Typical High $3,715.35 | Facility | None | $2,344.23 | $3,235.94 | $3,715.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $380.19 | Professional | None | $154.88 | $288.40 | $380.19 |
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 $138.04 Median $263.03 Typical High $501.19 | Professional | None | $138.04 | $263.03 | $501.19 |
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 $61.66 Median $89.13 Typical High $154.88 | Professional | 52 · Reduced service | $61.66 | $89.13 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $61.66 | Professional | 53 · Discontinued | $24.55 | $36.31 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $234.42 | Professional | 54 · Surgery only | $91.20 | $134.90 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.92 Typical High $46.77 | Professional | 55 · Aftercare only | $18.20 | $26.92 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.78 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.30 | $17.78 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $89.13 Typical High $154.88 | Professional | 52 · Reduced service | $61.66 | $89.13 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $61.66 | Professional | 53 · Discontinued | $24.55 | $36.31 | $61.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $234.42 | Professional | 54 · Surgery only | $91.20 | $134.90 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $26.92 Typical High $46.77 | Professional | 55 · Aftercare only | $18.20 | $26.92 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $30.90 |
Where Oregon sits
The same service costs 3.7 times more in Alaska than in Maryland. 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
$282
AK $355MD $95.50
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.