How much rates vary
Facilitymedian $1,514 · 10th to 90th $1,175 to $1,622Professionalmedian $955 · 10th to 90th $692 to $1,738
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 $891.25 Median $933.25 Typical High $933.25 | Professional | None | $891.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $954.99 | Professional | None | $691.83 | $691.83 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $3,311.31 Typical High $4,168.69 | Professional | None | $1,174.90 | $3,311.31 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,584.89 | Facility | None | $933.25 | $1,348.96 | $1,584.89 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $1,584.89 | Professional | None | $933.25 | $1,412.54 | $1,584.89 |
Pacific Source Setting Facility Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,621.81 | Facility | None | $1,230.27 | $1,513.56 | $1,621.81 |
Pacific Source Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,548.82 | $1,548.82 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,584.89 | Facility | None | $954.99 | $954.99 | $1,584.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $691.83 Typical High $1,513.56 | Professional | None | $79.43 | $691.83 | $1,513.56 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $6,025.60 | Facility | None | $1,258.93 | $2,454.71 | $6,025.60 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,090.30 | Facility | None | $2,290.87 | $2,290.87 | $3,090.30 |
United Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,380.38 | Professional | None | $660.69 | $707.95 | $1,380.38 |
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 $426.58 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $190.55 | $190.55 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Where Oregon sits
The same service costs 2.4 times more in Montana 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· 15th of 51
$1,230
MT $1,660DE $692
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.