How much rates vary
Facilitymedian $562 · 10th to 90th $417 to $5,129Professionalmedian $513 · 10th to 90th $288 to $759
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $426.58 | Professional | None | $288.40 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,698.24 Typical High $2,290.87 | Facility | None | $891.25 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $758.58 | Professional | None | $346.74 | $457.09 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $660.69 | Professional | None | $416.87 | $537.03 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $831.76 Typical High $8,709.64 | Facility | None | $467.74 | $831.76 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $691.83 | Professional | None | $389.05 | $426.58 | $691.83 |
Pacific Source Setting Facility Modifier None Typical Low $331.13 Median $549.54 Typical High $562.34 | Facility | None | $331.13 | $549.54 | $562.34 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $1,548.82 Typical High $2,290.87 | Facility | None | $575.44 | $1,548.82 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $812.83 | Professional | None | $79.43 | $537.03 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,677.35 Median $6,606.93 Typical High $7,585.78 | Facility | None | $4,677.35 | $6,606.93 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $758.58 | Professional | None | $537.03 | $562.34 | $758.58 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,413.10 | Facility | None | $602.56 | $1,000.00 | $7,413.10 |
United Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $870.96 | Professional | None | $416.87 | $524.81 | $870.96 |
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 $165.96 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $42.66 |
Where Oregon sits
The same service costs 5.2 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $4,508MT $873
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.