How much rates vary
Facilitymedian $1,413 · 10th to 90th $1,096 to $1,549Professionalmedian $891 · 10th to 90th $646 to $1,622
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 $831.76 Median $870.96 Typical High $870.96 | Professional | None | $831.76 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $3,090.30 Typical High $3,981.07 | Professional | None | $1,122.02 | $3,090.30 | $3,981.07 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,479.11 | Facility | None | $831.76 | $1,096.48 | $1,479.11 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,479.11 | Professional | None | $870.96 | $1,348.96 | $1,479.11 |
Pacific Source Setting Facility Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,548.82 | Facility | None | $1,148.15 | $1,412.54 | $1,548.82 |
Pacific Source Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $1,479.11 | Facility | None | $891.25 | $912.01 | $1,479.11 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $645.65 Typical High $1,412.54 | Professional | None | $79.43 | $645.65 | $1,412.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $5,623.41 | Facility | None | $1,174.90 | $2,344.23 | $5,623.41 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,513.56 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,019.95 | Facility | None | $2,238.72 | $2,238.72 | $3,019.95 |
United Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,348.96 | Professional | None | $616.60 | $691.83 | $1,348.96 |
8 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 $416.87 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $87.10 |
Where Oregon sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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
$1,148
HI $1,905DE $646
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.