How much rates vary
Facilitymedian $48 · 10th to 90th $28 to $9,333Professionalmedian $537 · 10th to 90th $166 to $1,349
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 $3,890.45 Median $6,025.60 Typical High $8,709.64 | Facility | None | $3,890.45 | $6,025.60 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $4,365.16 | Facility | None | $1,000.00 | $3,311.31 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $1,288.25 | Professional | None | $263.03 | $323.59 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $537.03 | Professional | None | $331.13 | $457.09 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $6,025.60 Typical High $8,709.64 | Facility | None | $891.25 | $6,025.60 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Pacific Source Setting Facility Modifier None Typical Low $26.30 Median $43.65 Typical High $47.86 | Facility | None | $26.30 | $43.65 | $47.86 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $3,090.30 Typical High $4,365.16 | Facility | None | $549.54 | $3,090.30 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $302.00 Typical High $1,202.26 | Professional | None | $70.79 | $302.00 | $1,202.26 |
Regence BlueShield Setting Facility Modifier None Typical Low $9,332.54 Median $12,022.64 Typical High $14,125.38 | Facility | None | $9,332.54 | $12,022.64 | $14,125.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $1,122.02 | Professional | None | $380.19 | $398.11 | $1,122.02 |
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 $134.90 Median $1,174.90 Typical High $2,137.96 | Professional | None | $134.90 | $1,174.90 | $2,137.96 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Where Oregon sits
The same service costs 53.7 times more in Alaska 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· 46th of 51
$525
AK $2,692NY $50.12
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.