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 $181.97 Median $331.13 Typical High $331.13 | Professional | None | $181.97 | $331.13 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $575.44 | Professional | None | $416.87 | $478.63 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $7,943.28 | Facility | None | $331.13 | $457.09 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $331.13 | Professional | None | $181.97 | $331.13 | $331.13 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $398.11 Typical High $446.68 | Facility | None | $257.04 | $398.11 | $446.68 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $478.63 | Facility | None | $331.13 | $457.09 | $478.63 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $645.65 | Professional | None | $70.79 | $79.43 | $645.65 |
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 $91.20 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $91.20 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $36.31 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $138.04 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $27.54 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $18.20 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $91.20 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $36.31 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $138.04 | $245.47 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $27.54 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $18.20 | $33.11 | $33.11 |
Where Oregon sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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
$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.