How much rates vary
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 $5,128.61 Median $7,943.28 Typical High $19,952.62 | Facility | None | $5,128.61 | $7,943.28 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | None | $478.63 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $23,988.33 | Facility | None | $549.54 | $1,000.00 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,096.48 | Professional | None | $575.44 | $660.69 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $870.96 | Professional | None | $588.84 | $724.44 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $741.31 Typical High $7,943.28 | Facility | None | $524.81 | $741.31 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | None | $478.63 | $524.81 | $524.81 |
Pacific Source Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $630.96 | Facility | None | $114.82 | $190.55 | $630.96 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $251,188.64 Typical High $251,188.64 | Facility | None | $691.83 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $575.44 Typical High $1,071.52 | Professional | None | $79.43 | $575.44 | $1,071.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $954.99 | Professional | None | $691.83 | $724.44 | $954.99 |
United Setting Facility Modifier None Typical Low $602.56 Median $870.96 Typical High $11,481.54 | Facility | None | $602.56 | $870.96 | $11,481.54 |
United Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $1,047.13 | Professional | None | $478.63 | $588.84 | $1,047.13 |
6 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 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $52.48 |
Where Oregon sits
The same service costs 15.1 times more in New York than in Hawaii. 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· 13th of 51
$631
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.