How much rates vary
Facilitymedian $195 · 10th to 90th $117 to $1,096Professionalmedian $191 · 10th to 90th $107 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 $123.03 Median $151.36 Typical High $151.36 | Professional | None | $123.03 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $295.12 | Professional | None | $138.04 | $169.82 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $295.12 | Professional | None | $181.97 | $229.09 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $269.15 | Facility | None | $151.36 | $234.42 | $269.15 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $229.09 | Professional | None | $151.36 | $169.82 | $229.09 |
Pacific Source Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $204.17 | Facility | None | $114.82 | $190.55 | $204.17 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $269.15 | Facility | None | $151.36 | $234.42 | $269.15 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $295.12 | Professional | None | $79.43 | $190.55 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,445.44 | Facility | None | $912.01 | $1,174.90 | $1,445.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $251.19 | Professional | None | $190.55 | $204.17 | $251.19 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,318.26 | $1,621.81 |
United Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $302.00 | Professional | None | $147.91 | $186.21 | $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 $61.66 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $61.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $72.44 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $28.84 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $15.14 |
Where Oregon sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 7th of 51
$191
AK $275FL $91.20
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.