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 $398.11 Median $436.52 Typical High $436.52 | Professional | None | $398.11 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $1,548.82 Typical High $1,949.84 | Professional | None | $549.54 | $1,548.82 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $537.03 Typical High $724.44 | Facility | None | $436.52 | $537.03 | $724.44 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $724.44 | Professional | None | $436.52 | $660.69 | $724.44 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $724.44 Typical High $758.58 | Facility | None | $645.65 | $724.44 | $758.58 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $562.34 Typical High $724.44 | Facility | None | $436.52 | $562.34 | $724.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $407.38 Typical High $691.83 | Professional | None | $79.43 | $407.38 | $691.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | None | $741.31 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,445.44 | Facility | None | $1,096.48 | $1,096.48 | $1,445.44 |
United Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $645.65 | Professional | None | $309.03 | $331.13 | $645.65 |
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 $60.26 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii than in Maryland. 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
$589
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.