How much rates vary
Facilitymedian $229 · 10th to 90th $138 to $9,333Professionalmedian $219 · 10th to 90th $123 to $331
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 $138.04 Median $169.82 Typical High $169.82 | Professional | None | $138.04 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $8,317.64 Typical High $11,220.18 | Facility | None | $660.69 | $8,317.64 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $316.23 | Professional | None | $154.88 | $186.21 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $281.84 | Professional | None | $181.97 | $229.09 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $338.84 Typical High $7,943.28 | Facility | None | $190.55 | $338.84 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $316.23 | Professional | None | $169.82 | $186.21 | $316.23 |
Pacific Source Setting Facility Modifier None Typical Low $134.90 Median $218.78 Typical High $234.42 | Facility | None | $134.90 | $218.78 | $234.42 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $7,585.78 Typical High $11,220.18 | Facility | None | $263.03 | $7,585.78 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $338.84 | Professional | None | $79.43 | $218.78 | $338.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $14,125.38 Median $19,952.62 Typical High $22,908.68 | Facility | None | $14,125.38 | $19,952.62 | $22,908.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $316.23 | Professional | None | $223.87 | $234.42 | $316.23 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $25,118.86 | Facility | None | $1,513.56 | $2,630.27 | $25,118.86 |
United Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $363.08 | Professional | None | $173.78 | $218.78 | $363.08 |
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 $67.61 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $67.61 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $26.92 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $100.00 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.49 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $79.43 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $31.62 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $117.49 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $23.44 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.85 | $16.98 | $16.98 |
Where Oregon sits
The same service costs 4.8 times more in Alaska 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· 8th of 51
$224
AK $468UT $97.72
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.