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 $1,698.24 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $6,606.93 Typical High $8,317.64 | Professional | None | $2,398.83 | $6,606.93 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,162.28 | Facility | None | $1,905.46 | $2,344.23 | $3,162.28 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,884.03 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,884.03 | $3,162.28 |
Pacific Source Setting Facility Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $3,467.37 | Facility | None | $2,454.71 | $3,019.95 | $3,467.37 |
Pacific Source Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,467.37 | Professional | None | $2,454.71 | $3,090.30 | $3,467.37 |
Providence Setting Facility Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $3,162.28 | Facility | None | $1,778.28 | $1,905.46 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,288.25 Typical High $3,019.95 | Professional | None | $79.43 | $1,288.25 | $3,019.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,511.89 Median $5,011.87 Typical High $12,022.64 | Facility | None | $2,511.89 | $5,011.87 | $12,022.64 |
Regence BlueShield Setting Professional Modifier None Typical Low $3,235.94 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,235.94 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $6,165.95 | Facility | None | $4,570.88 | $4,570.88 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,412.54 | $2,754.23 |
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 $851.14 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $954.99 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $380.19 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $190.55 |
Where Oregon sits
The same service costs 3.2 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· 13th of 51
$2,455
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.