How much rates vary
Facilitymedian $10,471 · 10th to 90th $7,586 to $13,804Professionalmedian $7,244 · 10th to 90th $4,677 to $12,023
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 $5,623.41 Median $6,456.54 Typical High $6,456.54 | Professional | None | $5,623.41 | $6,456.54 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8,128.31 Median $21,877.62 Typical High $27,542.29 | Professional | None | $8,128.31 | $21,877.62 | $27,542.29 |
Moda Health Setting Facility Modifier None Typical Low $6,456.54 Median $8,128.31 Typical High $10,964.78 | Facility | None | $6,456.54 | $8,128.31 | $10,964.78 |
Moda Health Setting Professional Modifier None Typical Low $6,456.54 Median $10,000.00 Typical High $10,964.78 | Professional | None | $6,456.54 | $10,000.00 | $10,964.78 |
Pacific Source Setting Facility Modifier None Typical Low $9,549.93 Median $10,715.19 Typical High $10,964.78 | Facility | None | $9,549.93 | $10,715.19 | $10,964.78 |
Providence Setting Facility Modifier None Typical Low $6,456.54 Median $7,585.78 Typical High $10,964.78 | Facility | None | $6,456.54 | $7,585.78 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $5,495.41 Typical High $10,471.29 | Professional | None | $79.43 | $5,495.41 | $10,471.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $8,709.64 Median $16,982.44 Typical High $41,686.94 | Facility | None | $8,709.64 | $16,982.44 | $41,686.94 |
Regence BlueShield Setting Professional Modifier None Typical Low $10,964.78 Median $12,022.64 Typical High $12,022.64 | Professional | None | $10,964.78 | $12,022.64 | $12,022.64 |
United Setting Facility Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $20,417.38 | Facility | None | $15,488.17 | $15,488.17 | $20,417.38 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $4,677.35 Typical High $9,120.11 | Professional | None | $4,365.16 | $4,677.35 | $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 $2,818.38 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $2,818.38 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $1,122.02 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 55 · Aftercare only | $851.14 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $562.34 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $3,235.94 | $3,235.94 | $3,235.94 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $1,288.25 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 55 · Aftercare only | $977.24 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $645.65 | $645.65 | $645.65 |
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
$8,710
MT $11,220PA $5,370
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.