How much rates vary
Facilitymedian $407 · 10th to 90th $229 to $617Professionalmedian $380 · 10th to 90th $204 to $631
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 $194.98 Median $316.23 Typical High $380.19 | Professional | None | $194.98 | $316.23 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $660.69 | Professional | None | $323.59 | $389.05 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $549.54 | Professional | None | $380.19 | $467.74 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $616.60 | Facility | None | $316.23 | $446.68 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $446.68 | Professional | None | $194.98 | $316.23 | $446.68 |
Pacific Source Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $457.09 | Facility | None | $245.47 | $407.38 | $457.09 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $380.19 Typical High $616.60 | Facility | None | $269.15 | $380.19 | $616.60 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $416.87 Typical High $660.69 | Professional | None | $79.43 | $416.87 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $794.33 | Facility | None | $524.81 | $691.83 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $575.44 | Professional | None | $416.87 | $457.09 | $575.44 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $741.31 | Professional | None | $281.84 | $371.54 | $741.31 |
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 $107.15 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $107.15 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $42.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $31.62 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.38 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $97.72 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $38.90 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $29.51 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.50 | $31.62 | $31.62 |
Where Oregon sits
The same service costs 3.0 times more in Wisconsin 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
$398
WI $537FL $182
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.