How much rates vary
Facilitymedian $9,120 · 10th to 90th $6,607 to $12,023Professionalmedian $6,026 · 10th to 90th $3,981 to $10,471
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 $4,786.30 Median $5,623.41 Typical High $5,623.41 | Professional | None | $4,786.30 | $5,623.41 | $5,623.41 |
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 $4,786.30 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,786.30 | $4,786.30 | $6,606.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,079.46 Median $18,620.87 Typical High $23,442.29 | Professional | None | $7,079.46 | $18,620.87 | $23,442.29 |
Moda Health Setting Facility Modifier None Typical Low $5,623.41 Median $7,079.46 Typical High $9,549.93 | Facility | None | $5,623.41 | $7,079.46 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $5,623.41 Median $8,709.64 Typical High $9,549.93 | Professional | None | $5,623.41 | $8,709.64 | $9,549.93 |
Pacific Source Setting Facility Modifier None Typical Low $8,317.64 Median $9,332.54 Typical High $9,772.37 | Facility | None | $8,317.64 | $9,332.54 | $9,772.37 |
Providence Setting Facility Modifier None Typical Low $5,754.40 Median $6,606.93 Typical High $9,549.93 | Facility | None | $5,754.40 | $6,606.93 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,786.30 Typical High $9,120.11 | Professional | None | $79.43 | $4,786.30 | $9,120.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,585.78 Median $14,791.08 Typical High $36,307.81 | Facility | None | $7,585.78 | $14,791.08 | $36,307.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $9,549.93 Median $10,471.29 Typical High $10,471.29 | Professional | None | $9,549.93 | $10,471.29 | $10,471.29 |
United Setting Facility Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $17,378.01 | Facility | None | $13,182.57 | $13,182.57 | $17,378.01 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $7,762.47 | Professional | None | $3,715.35 | $3,981.07 | $7,762.47 |
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 $2,398.83 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,398.83 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $954.99 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $724.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $478.63 | $562.34 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,818.38 | $2,818.38 | $2,818.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $1,148.15 | $1,148.15 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $562.34 | $562.34 | $562.34 |
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· 13th of 51
$7,586
MT $10,000PA $4,786
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.