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 $331.13 Median $363.08 Typical High $363.08 | Professional | None | $331.13 | $363.08 | $363.08 |
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 $380.19 Median $436.52 Typical High $724.44 | Professional | None | $380.19 | $436.52 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $630.96 | Professional | None | $398.11 | $489.78 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $512.86 Typical High $7,943.28 | Facility | None | $363.08 | $512.86 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | None | $331.13 | $363.08 | $363.08 |
Pacific Source Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $457.09 | Facility | None | $134.90 | $223.87 | $457.09 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $251,188.64 Typical High $251,188.64 | Facility | None | $549.54 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $380.19 Typical High $741.31 | Professional | None | $79.43 | $380.19 | $741.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $645.65 | Professional | None | $478.63 | $501.19 | $645.65 |
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 $331.13 Median $398.11 Typical High $691.83 | Professional | None | $331.13 | $398.11 | $691.83 |
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 $245.47 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $245.47 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $36.31 |
Where Oregon sits
The same service costs 8.1 times more in New York than in Missouri. 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· 12th of 51
$437
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.