How much rates vary
Facilitymedian $407 · 10th to 90th $219 to $3,162Professionalmedian $263 · 10th to 90th $129 to $501
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 $131.83 Median $213.80 Typical High $338.84 | Professional | None | $131.83 | $213.80 | $338.84 |
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 $128.82 Median $251.19 Typical High $524.81 | Professional | None | $128.82 | $251.19 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $575.44 | Professional | None | $162.18 | $245.47 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $398.11 Typical High $6,606.93 | Facility | None | $190.55 | $398.11 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $436.52 | Professional | None | $131.83 | $288.40 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $363.08 Typical High $426.58 | Facility | None | $218.78 | $363.08 | $426.58 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $1,000.00 Typical High $1,698.24 | Facility | None | $213.80 | $1,000.00 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $239.88 Typical High $524.81 | Professional | None | $79.43 | $239.88 | $524.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $4,677.35 | Facility | None | $3,019.95 | $4,168.69 | $4,677.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $426.58 | Professional | None | $169.82 | $323.59 | $426.58 |
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 $151.36 Median $281.84 Typical High $549.54 | Professional | None | $151.36 | $281.84 | $549.54 |
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 $66.07 Median $100.00 Typical High $169.82 | Professional | 52 · Reduced service | $66.07 | $100.00 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $39.81 Typical High $67.61 | Professional | 53 · Discontinued | $26.30 | $39.81 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $151.36 Typical High $251.19 | Professional | 54 · Surgery only | $100.00 | $151.36 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $50.12 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.95 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.18 | $19.95 | $33.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $100.00 Typical High $169.82 | Professional | 52 · Reduced service | $66.07 | $100.00 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $39.81 Typical High $67.61 | Professional | 53 · Discontinued | $26.30 | $39.81 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $151.36 Typical High $251.19 | Professional | 54 · Surgery only | $100.00 | $151.36 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $50.12 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.95 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.18 | $19.95 | $33.88 |
Where Oregon sits
The same service costs 4.2 times more in Alaska than in Washington, DC. 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
$295
AK $468DC $112
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.