How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,862 to $2,630Professionalmedian $1,698 · 10th to 90th $1,122 to $2,818
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 $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,348.96 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,288.25 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $5,248.07 Typical High $6,606.93 | Professional | None | $1,905.46 | $5,248.07 | $6,606.93 |
Moda Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,570.40 | Facility | None | $1,513.56 | $1,905.46 | $2,570.40 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $2,570.40 | Professional | None | $1,513.56 | $2,290.87 | $2,570.40 |
Pacific Source Setting Facility Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $2,570.40 | Facility | None | $1,995.26 | $2,454.71 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,570.40 | Facility | None | $1,513.56 | $1,737.80 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,288.25 Typical High $2,454.71 | Professional | None | $79.43 | $1,288.25 | $2,454.71 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,995.26 Median $3,981.07 Typical High $9,772.37 | Facility | None | $1,995.26 | $3,981.07 | $9,772.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,818.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,897.79 | Facility | None | $3,715.35 | $3,715.35 | $4,897.79 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,122.02 | $2,187.76 |
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 $676.08 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $758.58 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $302.00 | $302.00 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $151.36 |
Where Oregon sits
The same service costs 2.1 times more in Montana 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· 17th of 51
$1,995
MT $2,692PA $1,259
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.