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 $275.42 Median $275.42 Typical High $1,445.44 | Professional | None | $275.42 | $275.42 | $1,445.44 |
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 $316.23 Median $389.05 Typical High $602.56 | Professional | None | $316.23 | $389.05 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $537.03 | Professional | None | $380.19 | $436.52 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $7,943.28 | Facility | None | $275.42 | $389.05 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $1,445.44 | Professional | None | $275.42 | $275.42 | $1,445.44 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $181.97 Typical High $199.53 | Facility | None | $109.65 | $181.97 | $199.53 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $251,188.64 Typical High $251,188.64 | Facility | None | $426.58 | $251,188.64 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $645.65 | Professional | None | $79.43 | $316.23 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $660.69 | Professional | None | $416.87 | $436.52 | $660.69 |
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 $281.84 Median $398.11 Typical High $741.31 | Professional | None | $281.84 | $398.11 | $741.31 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
Where Oregon sits
The same service costs 8.5 times more in New York than in Kentucky. 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· 24th of 51
$363
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.