How much rates vary
Facilitymedian $513 · 10th to 90th $363 to $8,318Professionalmedian $501 · 10th to 90th $269 to $759
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 $9,549.93 Typical High $17,378.01 | Facility | None | $5,128.61 | $9,549.93 | $17,378.01 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,235.94 Typical High $4,365.16 | Facility | None | $1,000.00 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $707.95 | Professional | None | $354.81 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $588.84 | Professional | None | $426.58 | $501.19 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $707.95 Typical High $17,378.01 | Facility | None | $489.78 | $707.95 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $707.95 | Professional | None | $338.84 | $407.38 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $524.81 | Facility | None | $309.03 | $512.86 | $524.81 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $4,365.16 | Facility | None | $588.84 | $2,951.21 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $758.58 | Professional | None | $79.43 | $489.78 | $758.58 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,912.51 Median $12,022.64 Typical High $13,803.84 | Facility | None | $8,912.51 | $12,022.64 | $13,803.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $776.25 | Professional | None | $501.19 | $524.81 | $776.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $912.01 | Professional | None | $389.05 | $562.34 | $912.01 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $257.04 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Oregon sits
The same service costs 7.2 times more in Oklahoma than in New York. 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· 18th of 51
$513
OK $1,950NY $269
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.