How much rates vary
Facilitymedian $295 · 10th to 90th $112 to $2,951Professionalmedian $132 · 10th to 90th $60 to $389
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 $60.26 Median $154.88 Typical High $269.15 | Professional | None | $60.26 | $154.88 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $173.78 Typical High $416.87 | Professional | None | $60.26 | $173.78 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $169.82 Typical High $416.87 | Professional | None | $72.44 | $169.82 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $380.19 Typical High $6,606.93 | Facility | None | $81.28 | $380.19 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $162.18 Typical High $338.84 | Professional | None | $60.26 | $162.18 | $338.84 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $323.59 | Facility | None | $177.83 | $288.40 | $323.59 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $194.98 Typical High $758.58 | Facility | None | $63.10 | $194.98 | $758.58 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $416.87 | Professional | None | $66.07 | $120.23 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $3,630.78 | Facility | None | $2,290.87 | $3,162.28 | $3,630.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $77.62 Median $223.87 Typical High $323.59 | Professional | None | $77.62 | $223.87 | $323.59 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,981.07 | Facility | None | $354.81 | $660.69 | $3,981.07 |
United Setting Professional Modifier None Typical Low $66.07 Median $141.25 Typical High $416.87 | Professional | None | $66.07 | $141.25 | $416.87 |
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 $30.20 Median $70.79 Typical High $134.90 | Professional | 52 · Reduced service | $30.20 | $70.79 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $28.18 Typical High $53.70 | Professional | 53 · Discontinued | $12.02 | $28.18 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $104.71 Typical High $204.17 | Professional | 54 · Surgery only | $45.71 | $104.71 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $20.89 Typical High $40.74 | Professional | 55 · Aftercare only | $9.12 | $20.89 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $14.13 Typical High $26.92 | Professional | 56 · Pre-op care only | $6.03 | $14.13 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $70.79 Typical High $134.90 | Professional | 52 · Reduced service | $30.20 | $70.79 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $28.18 Typical High $53.70 | Professional | 53 · Discontinued | $12.02 | $28.18 | $53.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $104.71 Typical High $204.17 | Professional | 54 · Surgery only | $45.71 | $104.71 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $20.89 Typical High $40.74 | Professional | 55 · Aftercare only | $9.12 | $20.89 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $14.13 Typical High $26.92 | Professional | 56 · Pre-op care only | $6.03 | $14.13 | $26.92 |
Where Oregon sits
The same service costs 4.6 times more in Wisconsin 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
$191
WI $240DC $52.48
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.