How much rates vary
Facilitymedian $457 · 10th to 90th $309 to $4,169Professionalmedian $417 · 10th to 90th $282 to $646
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 $269.15 Median $346.74 Typical High $346.74 | Professional | None | $269.15 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,698.24 | Facility | None | $831.76 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $616.60 | Professional | None | $288.40 | $363.08 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $537.03 | Professional | None | $338.84 | $426.58 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $380.19 Median $5,011.87 Typical High $7,943.28 | Facility | None | $380.19 | $5,011.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $660.69 | Professional | None | $331.13 | $346.74 | $660.69 |
Pacific Source Setting Facility Modifier None Typical Low $269.15 Median $436.52 Typical High $457.09 | Facility | None | $269.15 | $436.52 | $457.09 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $1,230.27 Typical High $1,819.70 | Facility | None | $562.34 | $1,230.27 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $660.69 | Professional | None | $79.43 | $426.58 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $4,073.80 Typical High $4,677.35 | Facility | None | $3,019.95 | $4,073.80 | $4,677.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $602.56 | Professional | None | $426.58 | $457.09 | $602.56 |
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 $338.84 Median $426.58 Typical High $707.95 | Professional | None | $338.84 | $426.58 | $707.95 |
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 $134.90 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $134.90 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $199.53 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $40.74 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $61.66 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $234.42 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $30.90 | $34.67 | $34.67 |
Where Oregon sits
The same service costs 4.7 times more in Wyoming 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· 10th of 51
$427
WY $912UT $195
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.