How much rates vary
Facilitymedian $126 · 10th to 90th $60 to $240Professionalmedian $65 · 10th to 90th $60 to $158
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 $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $239.88 | Facility | None | $72.44 | $125.89 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $70.79 | Professional | None | $60.26 | $60.26 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $169.82 Typical High $218.78 | Professional | None | $109.65 | $169.82 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $151.36 | Facility | None | $60.26 | $63.10 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $77.62 | Professional | None | $60.26 | $72.44 | $77.62 |
Pacific Source Setting Facility Modifier None Typical Low $89.13 Median $109.65 Typical High $239.88 | Facility | None | $89.13 | $109.65 | $239.88 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $239.88 | Facility | None | $72.44 | $125.89 | $239.88 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $165.96 | Professional | None | $60.26 | $75.86 | $165.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $416.87 | Facility | None | $141.25 | $194.98 | $416.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | None | $54.95 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $60.26 Median $123.03 Typical High $144.54 | Facility | None | $60.26 | $123.03 | $144.54 |
United Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | None | $77.62 | $77.62 | $89.13 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 26th of 51
$67.61
HI $158CO $60.26
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.