How much rates vary
Facilitymedian $13,183 · 10th to 90th $9,120 to $17,378Professionalmedian $9,120 · 10th to 90th $6,166 to $15,136
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 $7,413.10 Median $8,128.31 Typical High $8,128.31 | Professional | None | $7,413.10 | $8,128.31 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10,232.93 Median $28,183.83 Typical High $35,481.34 | Professional | None | $10,232.93 | $28,183.83 | $35,481.34 |
Moda Health Setting Facility Modifier None Typical Low $8,128.31 Median $10,232.93 Typical High $13,803.84 | Facility | None | $8,128.31 | $10,232.93 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $8,128.31 Median $12,589.25 Typical High $13,803.84 | Professional | None | $8,128.31 | $12,589.25 | $13,803.84 |
Pacific Source Setting Facility Modifier None Typical Low $12,022.64 Median $13,489.63 Typical High $16,218.10 | Facility | None | $12,022.64 | $13,489.63 | $16,218.10 |
Providence Setting Facility Modifier None Typical Low $8,317.64 Median $9,120.11 Typical High $13,803.84 | Facility | None | $8,317.64 | $9,120.11 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $6,606.93 Typical High $13,182.57 | Professional | None | $79.43 | $6,606.93 | $13,182.57 |
Regence BlueShield Setting Facility Modifier None Typical Low $10,715.19 Median $21,379.62 Typical High $52,480.75 | Facility | None | $10,715.19 | $21,379.62 | $52,480.75 |
Regence BlueShield Setting Professional Modifier None Typical Low $13,803.84 Median $15,135.61 Typical High $15,135.61 | Professional | None | $13,803.84 | $15,135.61 | $15,135.61 |
United Setting Facility Modifier None Typical Low $19,952.62 Median $19,952.62 Typical High $26,915.35 | Facility | None | $19,952.62 | $19,952.62 | $26,915.35 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $6,165.95 Typical High $12,022.64 | Professional | None | $5,623.41 | $6,165.95 | $12,022.64 |
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 $3,715.35 Median $4,073.80 Typical High $4,073.80 | Professional | 52 · Reduced service | $3,715.35 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 53 · Discontinued | $1,479.11 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 55 · Aftercare only | $1,096.48 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 56 · Pre-op care only | $741.31 | $812.83 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | 52 · Reduced service | $4,073.80 | $4,073.80 | $4,073.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 53 · Discontinued | $1,621.81 | $1,621.81 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 55 · Aftercare only | $1,230.27 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 56 · Pre-op care only | $812.83 | $812.83 | $812.83 |
Where Oregon sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$10,965
MT $16,596DE $6,607
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.