How much rates vary
Facilitymedian $7,413 · 10th to 90th $6,026 to $9,120Professionalmedian $5,012 · 10th to 90th $3,090 to $9,333
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 $3,715.35 Median $5,011.87 Typical High $5,011.87 | Professional | None | $3,715.35 | $5,011.87 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,897.79 | Professional | None | $3,548.13 | $3,548.13 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,309.57 Median $14,454.40 Typical High $17,782.79 | Professional | None | $6,309.57 | $14,454.40 | $17,782.79 |
Moda Health Setting Facility Modifier None Typical Low $4,570.88 Median $6,165.95 Typical High $8,317.64 | Facility | None | $4,570.88 | $6,165.95 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $8,317.64 | Professional | None | $5,011.87 | $7,585.78 | $8,317.64 |
Pacific Source Setting Facility Modifier None Typical Low $6,606.93 Median $7,762.47 Typical High $8,317.64 | Facility | None | $6,606.93 | $7,762.47 | $8,317.64 |
Pacific Source Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
Providence Setting Facility Modifier None Typical Low $4,570.88 Median $5,011.87 Typical High $8,317.64 | Facility | None | $4,570.88 | $5,011.87 | $8,317.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,548.13 Typical High $8,128.31 | Professional | None | $79.43 | $3,548.13 | $8,128.31 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,606.93 Median $13,182.57 Typical High $31,622.78 | Facility | None | $6,606.93 | $13,182.57 | $31,622.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $8,511.38 Median $9,332.54 Typical High $9,332.54 | Professional | None | $8,511.38 | $9,332.54 | $9,332.54 |
United Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $13,489.63 | Facility | None | $10,000.00 | $10,000.00 | $13,489.63 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $6,025.60 | Professional | None | $2,818.38 | $3,090.30 | $6,025.60 |
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 $1,862.09 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $1,862.09 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $741.31 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $562.34 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $371.54 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,511.89 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $1,000.00 | $1,000.00 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $501.19 | $501.19 | $501.19 |
Where Oregon sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 12th of 51
$6,607
HI $11,482DC $3,311
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.