How much rates vary
Facilitymedian $5,888 · 10th to 90th $871 to $8,913Professionalmedian $7,762 · 10th to 90th $79 to $12,303
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 $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $870.96 | $3,235.94 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $5,754.40 Median $7,413.10 Typical High $11,481.54 | Professional | None | $5,754.40 | $7,413.10 | $11,481.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,585.78 Median $8,709.64 Typical High $10,471.29 | Professional | None | $7,585.78 | $8,709.64 | $10,471.29 |
Moda Health Setting Facility Modifier None Typical Low $5,888.44 Median $7,943.28 Typical High $8,317.64 | Facility | None | $5,888.44 | $7,943.28 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Pacific Source Setting Facility Modifier None Typical Low $5,011.87 Median $6,918.31 Typical High $8,317.64 | Facility | None | $5,011.87 | $6,918.31 | $8,317.64 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $5,888.44 | Facility | None | $1,000.00 | $3,388.44 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $6,025.60 Typical High $12,302.69 | Professional | None | $79.43 | $6,025.60 | $12,302.69 |
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 $7,943.28 Median $8,511.38 Typical High $12,589.25 | Professional | None | $7,943.28 | $8,511.38 | $12,589.25 |
United Setting Facility Modifier None Typical Low $602.56 Median $912.01 Typical High $11,481.54 | Facility | None | $602.56 | $912.01 | $11,481.54 |
United Setting Professional Modifier None Typical Low $5,754.40 Median $8,317.64 Typical High $15,135.61 | Professional | None | $5,754.40 | $8,317.64 | $15,135.61 |
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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $4,365.16 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $588.84 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $2,951.21 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $1,174.90 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $4,365.16 | $4,365.16 | $4,365.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $870.96 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $588.84 | $588.84 | $588.84 |
Where Oregon sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 5th of 51
$6,918
AK $14,125AR $3,236
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.