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 $2,570.40 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,570.40 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,089.30 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $10,000.00 Typical High $12,589.25 | Professional | None | $3,630.78 | $10,000.00 | $12,589.25 |
Moda Health Setting Facility Modifier None Typical Low $2,884.03 Median $4,073.80 Typical High $4,786.30 | Facility | None | $2,884.03 | $4,073.80 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,365.16 Typical High $4,786.30 | Professional | None | $2,884.03 | $4,365.16 | $4,786.30 |
Pacific Source Setting Facility Modifier None Typical Low $4,570.88 Median $4,677.35 Typical High $4,897.79 | Facility | None | $4,570.88 | $4,677.35 | $4,897.79 |
Providence Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $4,786.30 | Facility | None | $2,884.03 | $2,884.03 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,089.30 Typical High $4,570.88 | Professional | None | $79.43 | $2,089.30 | $4,570.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,801.89 Median $7,413.10 Typical High $18,197.01 | Facility | None | $3,801.89 | $7,413.10 | $18,197.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $4,897.79 Median $5,248.07 Typical High $5,248.07 | Professional | None | $4,897.79 | $5,248.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $9,332.54 | Facility | None | $7,079.46 | $7,079.46 | $9,332.54 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,137.96 | $4,168.69 |
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 $389.05 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $257.04 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
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
$3,890
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.