How much rates vary
Facilitymedian $209 · 10th to 90th $123 to $263Professionalmedian $151 · 10th to 90th $95 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 $134.90 Median $134.90 Typical High $138.04 | Professional | None | $134.90 | $134.90 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $239.88 | Professional | None | $107.15 | $114.82 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $288.40 | Professional | None | $194.98 | $229.09 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $229.09 Typical High $263.03 | Facility | None | $134.90 | $229.09 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $190.55 | Professional | None | $114.82 | $134.90 | $190.55 |
Pacific Source Setting Facility Modifier None Typical Low $123.03 Median $204.17 Typical High $208.93 | Facility | None | $123.03 | $204.17 | $208.93 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $229.09 Typical High $263.03 | Facility | None | $120.23 | $229.09 | $263.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $251.19 | Professional | None | $79.43 | $114.82 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $416.87 | Facility | None | $190.55 | $281.84 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $208.93 | Professional | None | $190.55 | $199.53 | $208.93 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $165.96 | Facility | None | $112.20 | $112.20 | $165.96 |
United Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $302.00 | Professional | None | $147.91 | $190.55 | $302.00 |
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 $64.57 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $64.57 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $25.70 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
Where Oregon sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 6th of 51
$155
AK $224KY $63.10
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.