How much rates vary
Facilitymedian $10,000 · 10th to 90th $7,244 to $13,183Professionalmedian $7,079 · 10th to 90th $4,571 to $11,482
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 $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
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 $7,762.47 Typical High $10,471.29 | Facility | None | $6,165.95 | $7,762.47 | $10,471.29 |
Moda Health Setting Professional Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $10,471.29 | Professional | None | $6,165.95 | $9,549.93 | $10,471.29 |
Pacific Source Setting Facility Modifier None Typical Low $9,120.11 Median $10,232.93 Typical High $10,471.29 | Facility | None | $9,120.11 | $10,232.93 | $10,471.29 |
Providence Setting Facility Modifier None Typical Low $6,309.57 Median $7,244.36 Typical High $10,471.29 | Facility | None | $6,309.57 | $7,244.36 | $10,471.29 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $5,248.07 Typical High $10,000.00 | Professional | None | $79.43 | $5,248.07 | $10,000.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,317.64 Median $16,218.10 Typical High $39,810.72 | Facility | None | $8,317.64 | $16,218.10 | $39,810.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $10,471.29 Median $11,481.54 Typical High $11,481.54 | Professional | None | $10,471.29 | $11,481.54 | $11,481.54 |
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 $9,120.11 | Professional | None | $4,265.80 | $4,570.88 | $9,120.11 |
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 $2,754.23 Median $3,090.30 Typical High $3,090.30 | Professional | 52 · Reduced service | $2,754.23 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $1,122.02 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 55 · Aftercare only | $831.76 | $933.25 | $933.25 |
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 52 · Reduced service Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | 52 · Reduced service | $3,090.30 | $3,090.30 | $3,090.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $1,230.27 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 55 · Aftercare only | $933.25 | $933.25 | $933.25 |
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 2.1 times more in Hawaii than in New Jersey. 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
HI $11,220NJ $5,248
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.