How much rates vary
Facilitymedian $398 · 10th to 90th $234 to $4,266Professionalmedian $302 · 10th to 90th $145 to $537
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 $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $302.00 | Professional | None | $120.23 | $190.55 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $1,905.46 | Facility | None | $660.69 | $1,412.54 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $575.44 | Professional | None | $177.83 | $302.00 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $489.78 | Professional | None | $199.53 | $302.00 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $426.58 Typical High $6,606.93 | Facility | None | $245.47 | $426.58 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $489.78 | Professional | None | $138.04 | $239.88 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $407.38 | Facility | None | $229.09 | $371.54 | $407.38 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,122.02 Typical High $1,905.46 | Facility | None | $302.00 | $1,122.02 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $302.00 Typical High $549.54 | Professional | None | $79.43 | $302.00 | $549.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,073.80 Median $5,623.41 Typical High $6,456.54 | Facility | None | $4,073.80 | $5,623.41 | $6,456.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $537.03 | Professional | None | $229.09 | $389.05 | $537.03 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $7,244.36 | Facility | None | $602.56 | $1,000.00 | $7,244.36 |
United Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $575.44 | Professional | None | $204.17 | $331.13 | $575.44 |
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 $87.10 Median $87.10 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $87.10 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $34.67 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $223.87 | Professional | 54 · Surgery only | $128.82 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $87.10 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $34.67 | $60.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $223.87 | Professional | 54 · Surgery only | $128.82 | $128.82 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $30.20 |
Where Oregon sits
The same service costs 4.0 times more in Alaska 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· 7th of 51
$331
AK $631KY $158
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.