How much rates vary
Facilitymedian $186 · 10th to 90th $93 to $282Professionalmedian $72 · 10th to 90th $26 to $191
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 $40.74 Median $61.66 Typical High $134.90 | Professional | None | $40.74 | $61.66 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $30.90 Typical High $67.61 | Professional | 52 · Reduced service | $20.42 | $30.90 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $12.30 Typical High $26.92 | Professional | 53 · Discontinued | $8.13 | $12.30 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.33 Typical High $19.95 | Professional | 55 · Aftercare only | $6.03 | $9.33 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.17 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.07 | $6.17 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $72.44 Typical High $151.36 | Professional | None | $25.70 | $72.44 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $97.72 Typical High $239.88 | Professional | None | $42.66 | $97.72 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $134.90 Typical High $223.87 | Facility | None | $57.54 | $134.90 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $85.11 Typical High $134.90 | Professional | None | $40.74 | $85.11 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $30.90 Typical High $67.61 | Professional | 52 · Reduced service | $20.42 | $30.90 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $12.30 Typical High $26.92 | Professional | 53 · Discontinued | $8.13 | $12.30 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.33 Typical High $19.95 | Professional | 55 · Aftercare only | $6.03 | $9.33 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.17 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.07 | $6.17 | $13.49 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $173.78 Typical High $204.17 | Facility | None | $109.65 | $173.78 | $204.17 |
Providence Setting Facility Modifier None Typical Low $47.86 Median $131.83 Typical High $281.84 | Facility | None | $47.86 | $131.83 | $281.84 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $79.43 Typical High $194.98 | Professional | None | $25.70 | $79.43 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $173.78 Median $354.81 Typical High $512.86 | Facility | None | $173.78 | $354.81 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $138.04 | Professional | None | $36.31 | $54.95 | $138.04 |
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 $57.54 Typical High $165.96 | Professional | None | $33.11 | $57.54 | $165.96 |
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 3.5 times more in Hawaii 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· 20th of 51
$72.44
HI $135MD $38.02
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.