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 $5,495.41 Median $6,165.95 Typical High $6,165.95 | Professional | None | $5,495.41 | $6,165.95 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,762.47 Median $21,379.62 Typical High $26,915.35 | Professional | None | $7,762.47 | $21,379.62 | $26,915.35 |
Moda Health Setting Facility Modifier None Typical Low $6,165.95 Median $7,585.78 Typical High $10,232.93 | Facility | None | $6,165.95 | $7,585.78 | $10,232.93 |
Moda Health Setting Professional Modifier None Typical Low $6,165.95 Median $9,332.54 Typical High $10,232.93 | Professional | None | $6,165.95 | $9,332.54 | $10,232.93 |
Pacific Source Setting Facility Modifier None Typical Low $9,772.37 Median $10,000.00 Typical High $10,471.29 | Facility | None | $9,772.37 | $10,000.00 | $10,471.29 |
Providence Setting Facility Modifier None Typical Low $6,165.95 Median $6,606.93 Typical High $10,232.93 | Facility | None | $6,165.95 | $6,606.93 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,897.79 Typical High $9,772.37 | Professional | None | $79.43 | $4,897.79 | $9,772.37 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,128.31 Median $15,848.93 Typical High $38,904.51 | Facility | None | $8,128.31 | $15,848.93 | $38,904.51 |
Regence BlueShield Setting Professional Modifier None Typical Low $10,471.29 Median $11,220.18 Typical High $11,220.18 | Professional | None | $10,471.29 | $11,220.18 | $11,220.18 |
United Setting Facility Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $19,952.62 | Facility | None | $15,135.61 | $15,135.61 | $19,952.62 |
United Setting Professional Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $8,912.51 | Professional | None | $4,265.80 | $4,570.88 | $8,912.51 |
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 $831.76 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 56 · Pre-op care only | $549.54 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $912.01 | $912.01 | $912.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 56 · Pre-op care only | $616.60 | $616.60 | $616.60 |
Where Oregon sits
The same service costs 2.3 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· 15th of 51
$8,318
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.