How much rates vary
Facilitymedian $4,786 · 10th to 90th $3,802 to $5,495Professionalmedian $3,548 · 10th to 90th $2,399 to $6,026
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 $2,884.03 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,884.03 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,168.69 Median $11,220.18 Typical High $14,125.38 | Professional | None | $4,168.69 | $11,220.18 | $14,125.38 |
Moda Health Setting Facility Modifier None Typical Low $3,311.31 Median $4,073.80 Typical High $5,495.41 | Facility | None | $3,311.31 | $4,073.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $3,311.31 Median $5,011.87 Typical High $5,495.41 | Professional | None | $3,311.31 | $5,011.87 | $5,495.41 |
Pacific Source Setting Facility Modifier None Typical Low $4,265.80 Median $4,897.79 Typical High $5,370.32 | Facility | None | $4,265.80 | $4,897.79 | $5,370.32 |
Pacific Source Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Providence Setting Facility Modifier None Typical Low $3,311.31 Median $3,548.13 Typical High $5,495.41 | Facility | None | $3,311.31 | $3,548.13 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,630.27 Typical High $5,248.07 | Professional | None | $79.43 | $2,630.27 | $5,248.07 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,365.16 Median $8,511.38 Typical High $20,892.96 | Facility | None | $4,365.16 | $8,511.38 | $20,892.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,623.41 Median $6,025.60 Typical High $6,025.60 | Professional | None | $5,623.41 | $6,025.60 | $6,025.60 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $10,471.29 | Facility | None | $7,943.28 | $7,943.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $4,677.35 | Professional | None | $2,238.72 | $2,398.83 | $4,677.35 |
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 $1,445.44 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,445.44 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $575.44 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $288.40 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,659.59 | $1,659.59 | $1,659.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $331.13 |
Where Oregon sits
The same service costs 4.3 times more in Hawaii than in Pennsylvania. 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
$4,266
HI $11,220PA $2,630
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.