How much rates vary
Facilitymedian $5,623 · 10th to 90th $4,266 to $6,457Professionalmedian $3,467 · 10th to 90th $2,291 to $6,457
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 $2,754.23 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,754.23 | $3,467.37 | $3,467.37 |
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 $2,570.40 Median $2,570.40 Typical High $3,548.13 | Professional | None | $2,570.40 | $2,570.40 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,365.16 Median $10,715.19 Typical High $13,182.57 | Professional | None | $4,365.16 | $10,715.19 | $13,182.57 |
Moda Health Setting Facility Modifier None Typical Low $3,311.31 Median $4,365.16 Typical High $5,888.44 | Facility | None | $3,311.31 | $4,365.16 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $5,888.44 | Professional | None | $3,467.37 | $5,248.07 | $5,888.44 |
Pacific Source Setting Facility Modifier None Typical Low $4,570.88 Median $5,623.41 Typical High $6,025.60 | Facility | None | $4,570.88 | $5,623.41 | $6,025.60 |
Pacific Source Setting Professional Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $6,309.57 | Professional | None | $5,128.61 | $5,754.40 | $6,309.57 |
Providence Setting Facility Modifier None Typical Low $3,311.31 Median $3,548.13 Typical High $5,888.44 | Facility | None | $3,311.31 | $3,548.13 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,570.40 Typical High $5,623.41 | Professional | None | $79.43 | $2,570.40 | $5,623.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $4,570.88 Median $9,120.11 Typical High $21,877.62 | Facility | None | $4,570.88 | $9,120.11 | $21,877.62 |
Regence BlueShield Setting Professional Modifier None Typical Low $5,888.44 Median $6,456.54 Typical High $6,456.54 | Professional | None | $5,888.44 | $6,456.54 | $6,456.54 |
United Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $10,000.00 | Facility | None | $7,413.10 | $7,413.10 | $10,000.00 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,290.87 | $4,466.84 |
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 $1,380.38 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,380.38 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $549.54 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $416.87 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $275.42 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $691.83 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $524.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $346.74 |
Where Oregon sits
The same service costs 3.0 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· 12th of 51
$4,571
HI $7,413PA $2,455
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.