How much rates vary
Facilitymedian $1,622 · 10th to 90th $661 to $3,162Professionalmedian $275 · 10th to 90th $123 to $2,239
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 $125.89 Median $912.01 Typical High $1,659.59 | Professional | None | $125.89 | $912.01 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $1,698.24 | Facility | None | $660.69 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $354.81 Typical High $2,454.71 | Professional | None | $123.03 | $354.81 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $2,570.40 | Professional | None | $151.36 | $234.42 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $1,905.46 Typical High $6,606.93 | Facility | None | $181.97 | $1,905.46 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $1,047.13 Typical High $1,905.46 | Professional | None | $125.89 | $1,047.13 | $1,905.46 |
Pacific Source Setting Facility Modifier None Typical Low $1,047.13 Median $1,698.24 Typical High $1,862.09 | Facility | None | $1,047.13 | $1,698.24 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $1,258.93 Typical High $2,511.89 | Facility | None | $208.93 | $1,258.93 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $251.19 Typical High $2,454.71 | Professional | None | $79.43 | $251.19 | $2,454.71 |
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 $162.18 Median $1,445.44 Typical High $1,862.09 | Professional | None | $162.18 | $1,445.44 | $1,862.09 |
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 $141.25 Median $794.33 Typical High $2,454.71 | Professional | None | $141.25 | $794.33 | $2,454.71 |
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 $63.10 Median $407.38 Typical High $812.83 | Professional | 52 · Reduced service | $63.10 | $407.38 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $165.96 Typical High $331.13 | Professional | 53 · Discontinued | $25.12 | $165.96 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $616.60 Typical High $1,230.27 | Professional | 54 · Surgery only | $95.50 | $616.60 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $123.03 Typical High $245.47 | Professional | 55 · Aftercare only | $19.05 | $123.03 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $81.28 Typical High $165.96 | Professional | 56 · Pre-op care only | $12.59 | $81.28 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $229.09 Typical High $812.83 | Professional | 52 · Reduced service | $63.10 | $229.09 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $91.20 Typical High $331.13 | Professional | 53 · Discontinued | $25.12 | $91.20 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $338.84 Typical High $1,230.27 | Professional | 54 · Surgery only | $95.50 | $338.84 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $67.61 Typical High $245.47 | Professional | 55 · Aftercare only | $19.05 | $67.61 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $95.50 Typical High $165.96 | Professional | 56 · Pre-op care only | $12.59 | $95.50 | $165.96 |
Where Oregon sits
The same service costs 14.1 times more in Washington 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· 4th of 51
$1,096
WA $1,288KY $91.20
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.