How much rates vary
Facilitymedian $245 · 10th to 90th $148 to $324Professionalmedian $162 · 10th to 90th $117 to $282
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 $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $288.40 | Professional | None | $128.82 | $138.04 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $338.84 | Professional | None | $234.42 | $269.15 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $295.12 Typical High $380.19 | Facility | None | $162.18 | $295.12 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $245.47 | Professional | None | $138.04 | $162.18 | $245.47 |
Pacific Source Setting Facility Modifier None Typical Low $147.91 Median $245.47 Typical High $257.04 | Facility | None | $147.91 | $245.47 | $257.04 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $295.12 Typical High $380.19 | Facility | None | $144.54 | $295.12 | $380.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $158.49 Typical High $302.00 | Professional | None | $79.43 | $158.49 | $302.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $338.84 Typical High $501.19 | Facility | None | $223.87 | $338.84 | $501.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $154.88 | Professional | None | $141.25 | $147.91 | $154.88 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $194.98 | Facility | None | $134.90 | $134.90 | $194.98 |
United Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $354.81 | Professional | None | $181.97 | $229.09 | $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 $81.28 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $16.22 |
Where Oregon sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 18th of 51
$162
AK $269IN $95.50
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.