How much rates vary
Facilitymedian $10,000 · 10th to 90th $6,310 to $10,233Professionalmedian $6,166 · 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 $5,754.40 Median $6,165.95 Typical High $6,165.95 | Professional | None | $5,754.40 | $6,165.95 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,762.47 Median $20,892.96 Typical High $26,302.68 | Professional | None | $7,762.47 | $20,892.96 | $26,302.68 |
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 $10,000.00 Typical High $10,715.19 | Professional | None | $6,165.95 | $10,000.00 | $10,715.19 |
Pacific Source Setting Facility Modifier None Typical Low $9,120.11 Median $10,000.00 Typical High $10,232.93 | Facility | None | $9,120.11 | $10,000.00 | $10,232.93 |
Providence Setting Facility Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $9,772.37 | Facility | None | $5,623.41 | $6,309.57 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,786.30 Typical High $10,000.00 | Professional | None | $79.43 | $4,786.30 | $10,000.00 |
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 Professional Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $8,912.51 | Professional | None | $4,265.80 | $4,570.88 | $8,912.51 |
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 $3,090.30 Typical High $3,090.30 | Professional | 52 · Reduced service | $2,818.38 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 53 · Discontinued | $1,148.15 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 55 · Aftercare only | $851.14 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 56 · Pre-op care only | $575.44 | $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 2.6 times more in Montana than in New York. 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· 12th of 51
$8,511
MT $10,715NY $4,169
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.