How much rates vary
Facilitymedian $204 · 10th to 90th $126 to $5,129Professionalmedian $195 · 10th to 90th $110 to $288
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 $120.23 Median $154.88 Typical High $154.88 | Professional | None | $120.23 | $154.88 | $154.88 |
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 $131.83 Median $165.96 Typical High $281.84 | Professional | None | $131.83 | $165.96 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $239.88 | Professional | None | $169.82 | $194.98 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $251.19 Typical High $7,943.28 | Facility | None | $162.18 | $251.19 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $251.19 | Professional | None | $154.88 | $165.96 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $213.80 | Facility | None | $125.89 | $199.53 | $213.80 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $251,188.64 Typical High $251,188.64 | Facility | None | $213.80 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $309.03 | Professional | None | $79.43 | $194.98 | $309.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $281.84 | Professional | None | $199.53 | $213.80 | $281.84 |
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 $158.49 Median $199.53 Typical High $331.13 | Professional | None | $158.49 | $199.53 | $331.13 |
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 $58.88 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $58.88 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.44 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $87.10 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $17.38 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.75 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $70.79 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $28.18 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $107.15 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $21.38 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $14.13 | $15.49 | $15.49 |
Where Oregon sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$200
AK $427NJ $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.