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 $616.60 Median $630.96 Typical High $630.96 | Professional | None | $616.60 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $2,238.72 Typical High $2,818.38 | Professional | None | $794.33 | $2,238.72 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $891.25 Typical High $1,071.52 | Facility | None | $630.96 | $891.25 | $1,071.52 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,071.52 | Professional | None | $630.96 | $870.96 | $1,071.52 |
Pacific Source Setting Facility Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,096.48 | Facility | None | $831.76 | $1,023.29 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $724.44 Typical High $1,071.52 | Facility | None | $645.65 | $724.44 | $1,071.52 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $1,023.29 | Professional | None | $79.43 | $537.03 | $1,023.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $851.14 Median $1,659.59 Typical High $4,073.80 | Facility | None | $851.14 | $1,659.59 | $4,073.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,071.52 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,089.30 | Facility | None | $1,584.89 | $1,584.89 | $2,089.30 |
United Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $933.25 | Professional | None | $436.52 | $478.63 | $933.25 |
4 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 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $63.10 |
Where Oregon sits
The same service costs 2.0 times more in Montana than in West Virginia. 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· 16th of 51
$832
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.