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 $380.19 Median $478.63 Typical High $478.63 | Professional | None | $380.19 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $1,380.38 Typical High $1,737.80 | Professional | None | $602.56 | $1,380.38 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $602.56 Typical High $812.83 | Facility | None | $398.11 | $602.56 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $812.83 | Professional | None | $478.63 | $724.44 | $812.83 |
Pacific Source Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $794.33 | Facility | None | $630.96 | $776.25 | $794.33 |
Pacific Source Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $489.78 Typical High $812.83 | Facility | None | $380.19 | $489.78 | $812.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $275.42 Typical High $776.25 | Professional | None | $79.43 | $275.42 | $776.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $645.65 Median $1,258.93 Typical High $3,090.30 | Facility | None | $645.65 | $1,258.93 | $3,090.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | None | $812.83 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Facility | None | $977.24 | $977.24 | $1,288.25 |
United Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $588.84 | Professional | None | $275.42 | $295.12 | $588.84 |
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 $53.70 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $53.70 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $35.48 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $47.86 |
Where Oregon sits
The same service costs 3.7 times more in Alaska 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· 11th of 51
$631
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.