How much rates vary
Facilitymedian $229 · 10th to 90th $117 to $380Professionalmedian $100 · 10th to 90th $50 to $224
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 $75.86 Median $97.72 Typical High $162.18 | Professional | None | $75.86 | $97.72 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $48.98 Typical High $81.28 | Professional | 52 · Reduced service | $38.90 | $48.98 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.50 Typical High $32.36 | Professional | 53 · Discontinued | $15.85 | $19.50 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.79 Typical High $23.99 | Professional | 55 · Aftercare only | $11.75 | $14.79 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.77 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.76 | $9.77 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $204.17 | Professional | None | $50.12 | $91.20 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $275.42 | Professional | None | $79.43 | $131.83 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $281.84 | Facility | None | $112.20 | $169.82 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $162.18 | Professional | None | $79.43 | $112.20 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $48.98 Typical High $81.28 | Professional | 52 · Reduced service | $38.90 | $48.98 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.50 Typical High $32.36 | Professional | 53 · Discontinued | $15.85 | $19.50 | $32.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.79 Typical High $23.99 | Professional | 55 · Aftercare only | $11.75 | $14.79 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.77 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.76 | $9.77 | $16.22 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $223.87 Typical High $245.47 | Facility | None | $117.49 | $223.87 | $245.47 |
Providence Setting Facility Modifier None Typical Low $89.13 Median $169.82 Typical High $309.03 | Facility | None | $89.13 | $169.82 | $309.03 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $114.82 Typical High $234.42 | Professional | None | $50.12 | $114.82 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $512.86 | Facility | None | $323.59 | $446.68 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $165.96 | Professional | None | $70.79 | $104.71 | $165.96 |
United Setting Facility Modifier None Typical Low $426.58 Median $524.81 Typical High $660.69 | Facility | None | $426.58 | $524.81 | $660.69 |
United Setting Professional Modifier None Typical Low $33.11 Median $107.15 Typical High $204.17 | Professional | None | $33.11 | $107.15 | $204.17 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Oregon sits
The same service costs 2.8 times more in Alaska than in Maryland. 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
$105
AK $178MD $64.57
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.