How much rates vary
Facilitymedian $427 · 10th to 90th $234 to $3,162Professionalmedian $302 · 10th to 90th $158 to $525
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 $165.96 Median $213.80 Typical High $346.74 | Professional | None | $165.96 | $213.80 | $346.74 |
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 $158.49 Median $295.12 Typical High $549.54 | Professional | None | $158.49 | $295.12 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $588.84 | Professional | None | $194.98 | $295.12 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $436.52 Typical High $6,606.93 | Facility | None | $234.42 | $436.52 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $457.09 | Professional | None | $165.96 | $302.00 | $457.09 |
Pacific Source Setting Facility Modifier None Typical Low $223.87 Median $371.54 Typical High $446.68 | Facility | None | $223.87 | $371.54 | $446.68 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $1,000.00 Typical High $1,698.24 | Facility | None | $269.15 | $1,000.00 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $288.40 Typical High $549.54 | Professional | None | $79.43 | $288.40 | $549.54 |
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 $208.93 Median $354.81 Typical High $446.68 | Professional | None | $208.93 | $354.81 | $446.68 |
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 $186.21 Median $309.03 Typical High $575.44 | Professional | None | $186.21 | $309.03 | $575.44 |
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 $83.18 Median $104.71 Typical High $173.78 | Professional | 52 · Reduced service | $83.18 | $104.71 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $69.18 | Professional | 53 · Discontinued | $33.11 | $41.69 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $158.49 Typical High $263.03 | Professional | 54 · Surgery only | $123.03 | $158.49 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $52.48 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $34.67 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $104.71 Typical High $173.78 | Professional | 52 · Reduced service | $83.18 | $104.71 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $69.18 | Professional | 53 · Discontinued | $33.11 | $41.69 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $158.49 Typical High $263.03 | Professional | 54 · Surgery only | $123.03 | $158.49 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $52.48 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $34.67 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $34.67 |
Where Oregon sits
The same service costs 3.8 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· 5th of 51
$324
AK $490DC $129
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.