How much rates vary
Facilitymedian $617 · 10th to 90th $309 to $2,138Professionalmedian $457 · 10th to 90th $245 to $1,000
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 $229.09 Median $251.19 Typical High $549.54 | Professional | None | $229.09 | $251.19 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $2,137.96 | Facility | None | $660.69 | $1,000.00 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $758.58 | Professional | None | $302.00 | $457.09 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $1,000.00 Typical High $7,943.28 | Facility | None | $323.59 | $1,000.00 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $524.81 Typical High $831.76 | Professional | None | $229.09 | $524.81 | $831.76 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $616.60 Typical High $1,000.00 | Facility | None | $436.52 | $616.60 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $660.69 Typical High $11,481.54 | Facility | None | $165.96 | $660.69 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $1,047.13 | Professional | None | $79.43 | $398.11 | $1,047.13 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,071.52 | $1,412.54 | $1,621.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $575.44 Typical High $1,000.00 | Professional | None | $288.40 | $575.44 | $1,000.00 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $346.74 Median $616.60 Typical High $1,071.52 | Professional | None | $346.74 | $616.60 | $1,071.52 |
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 $114.82 Median $125.89 Typical High $275.42 | Professional | 52 · Reduced service | $114.82 | $125.89 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $109.65 | Professional | 53 · Discontinued | $45.71 | $50.12 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $190.55 Typical High $407.38 | Professional | 54 · Surgery only | $169.82 | $190.55 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $81.28 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $22.91 | $25.12 | $54.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $114.82 Typical High $275.42 | Professional | 52 · Reduced service | $114.82 | $114.82 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $109.65 | Professional | 53 · Discontinued | $45.71 | $45.71 | $109.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $407.38 | Professional | 54 · Surgery only | $169.82 | $169.82 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $81.28 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $54.95 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $54.95 |
Where Oregon sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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· 4th of 51
$550
WI $813UT $288
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.