How much rates vary
Facilitymedian $42,658 · 10th to 90th $30,200 to $57,544Professionalmedian $29,512 · 10th to 90th $19,498 to $48,978
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 $23,442.29 Median $26,915.35 Typical High $26,915.35 | Professional | None | $23,442.29 | $26,915.35 | $26,915.35 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $22,387.21 | Professional | None | $22,387.21 | $22,387.21 | $22,387.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33,884.42 Median $91,201.08 Typical High $114,815.36 | Professional | None | $33,884.42 | $91,201.08 | $114,815.36 |
Moda Health Setting Facility Modifier None Typical Low $26,915.35 Median $33,113.11 Typical High $44,668.36 | Facility | None | $26,915.35 | $33,113.11 | $44,668.36 |
Moda Health Setting Professional Modifier None Typical Low $26,915.35 Median $40,738.03 Typical High $44,668.36 | Professional | None | $26,915.35 | $40,738.03 | $44,668.36 |
Pacific Source Setting Facility Modifier None Typical Low $41,686.94 Median $42,657.95 Typical High $43,651.58 | Facility | None | $41,686.94 | $42,657.95 | $43,651.58 |
Providence Setting Facility Modifier None Typical Low $26,915.35 Median $30,199.52 Typical High $44,668.36 | Facility | None | $26,915.35 | $30,199.52 | $44,668.36 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $22,387.21 Typical High $42,657.95 | Professional | None | $79.43 | $22,387.21 | $42,657.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $35,481.34 Median $69,183.10 Typical High $169,824.37 | Facility | None | $35,481.34 | $69,183.10 | $169,824.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $45,708.82 Median $48,977.88 Typical High $48,977.88 | Professional | None | $45,708.82 | $48,977.88 | $48,977.88 |
United Setting Facility Modifier None Typical Low $64,565.42 Median $64,565.42 Typical High $85,113.80 | Facility | None | $64,565.42 | $64,565.42 | $85,113.80 |
United Setting Professional Modifier None Typical Low $18,197.01 Median $19,498.45 Typical High $38,018.94 | Professional | None | $18,197.01 | $19,498.45 | $38,018.94 |
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 $11,748.98 Median $13,489.63 Typical High $13,489.63 | Professional | 52 · Reduced service | $11,748.98 | $13,489.63 | $13,489.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4,677.35 Median $5,370.32 Typical High $5,370.32 | Professional | 53 · Discontinued | $4,677.35 | $5,370.32 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3,548.13 Median $3,981.07 Typical High $3,981.07 | Professional | 55 · Aftercare only | $3,548.13 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2,344.23 Median $2,691.53 Typical High $2,691.53 | Professional | 56 · Pre-op care only | $2,344.23 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Professional | 52 · Reduced service | $13,489.63 | $13,489.63 | $13,489.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | 53 · Discontinued | $5,370.32 | $5,370.32 | $5,370.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | 55 · Aftercare only | $3,981.07 | $3,981.07 | $3,981.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 56 · Pre-op care only | $2,691.53 | $2,691.53 | $2,691.53 |
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· 14th of 51
$36,308
HI $47,863NJ $22,387
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.