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 Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $616.60 | Professional | None | $436.52 | $512.86 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $269.15 Typical High $338.84 | Facility | None | $190.55 | $269.15 | $338.84 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Pacific Source Setting Facility Modifier None Typical Low $275.42 Median $426.58 Typical High $478.63 | Facility | None | $275.42 | $426.58 | $478.63 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $338.84 | Facility | None | $199.53 | $288.40 | $338.84 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $691.83 | Professional | None | $70.79 | $79.43 | $691.83 |
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 $141.25 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Where Oregon sits
The same service costs 17.8 times more in Texas than in New Jersey. 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· 11th of 51
$389
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.