How much rates vary
Facilitymedian $200 · 10th to 90th $132 to $4,169Professionalmedian $182 · 10th to 90th $85 to $302
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 Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $165.96 | Facility | None | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $131.83 | Professional | None | $85.11 | $107.15 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,235.94 Typical High $4,466.84 | Facility | None | $660.69 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $269.15 | Professional | None | $138.04 | $181.97 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $234.42 | Professional | None | $169.82 | $194.98 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $2,691.53 Typical High $7,413.10 | Facility | None | $131.83 | $2,691.53 | $7,413.10 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $302.00 | Professional | None | $93.33 | $134.90 | $302.00 |
Pacific Source Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $208.93 | Facility | None | $120.23 | $194.98 | $208.93 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $194.98 Typical High $288.40 | Facility | None | $102.33 | $194.98 | $288.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $302.00 | Professional | None | $79.43 | $194.98 | $302.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $7,413.10 Median $10,715.19 Typical High $12,589.25 | Facility | None | $7,413.10 | $10,715.19 | $12,589.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $309.03 | Professional | None | $194.98 | $208.93 | $309.03 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $12,302.69 | Facility | None | $1,230.27 | $1,862.09 | $12,302.69 |
United Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $354.81 | Professional | None | $151.36 | $218.78 | $354.81 |
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 $53.70 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $53.70 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Where Oregon sits
The same service costs 7.9 times more in Kansas 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· 17th of 51
$195
KS $832NY $105
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.