How much rates vary
Facilitymedian $95 · 10th to 90th $58 to $204Professionalmedian $68 · 10th to 90th $43 to $132
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 $26.92 Median $42.66 Typical High $67.61 | Professional | None | $26.92 | $42.66 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $2,511.89 | Facility | None | $549.54 | $870.96 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $120.23 | Professional | None | $51.29 | $79.43 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $7,943.28 | Facility | None | $60.26 | $89.13 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $31.62 Median $57.54 Typical High $104.71 | Professional | None | $31.62 | $57.54 | $104.71 |
Pacific Source Setting Facility Modifier None Typical Low $57.54 Median $95.50 Typical High $104.71 | Facility | None | $57.54 | $95.50 | $104.71 |
Providence Setting Facility Modifier None Typical Low $36.31 Median $89.13 Typical High $660.69 | Facility | None | $36.31 | $89.13 | $660.69 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $141.25 | Professional | None | $46.77 | $79.43 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $141.25 | Professional | None | $53.70 | $85.11 | $141.25 |
United Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $4,897.79 | Facility | None | $151.36 | $275.42 | $4,897.79 |
United Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $147.91 | Professional | None | $54.95 | $89.13 | $147.91 |
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 $21.38 Median $21.38 Typical High $33.11 | Professional | 52 · Reduced service | $21.38 | $21.38 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $13.49 | Professional | 53 · Discontinued | $8.51 | $8.51 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $50.12 | Professional | 54 · Surgery only | $31.62 | $31.62 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $10.00 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.38 Typical High $33.11 | Professional | 52 · Reduced service | $21.38 | $21.38 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $13.49 | Professional | 53 · Discontinued | $8.51 | $8.51 | $13.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $50.12 | Professional | 54 · Surgery only | $31.62 | $31.62 | $50.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $10.00 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $6.76 |
Where Oregon sits
The same service costs 2.8 times more in Alaska than in California. 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
$83.18
AK $129CA $46.77
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.