How much rates vary
Facilitymedian $200 · 10th to 90th $162 to $229Professionalmedian $132 · 10th to 90th $91 to $251
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 $109.65 Median $131.83 Typical High $131.83 | Professional | None | $109.65 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $426.58 Typical High $537.03 | Professional | None | $169.82 | $426.58 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $223.87 | Facility | None | $112.20 | $165.96 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $223.87 | Professional | None | $131.83 | $204.17 | $223.87 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $199.53 Typical High $223.87 | Facility | None | $177.83 | $199.53 | $223.87 |
Pacific Source Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | None | $181.97 | $223.87 | $223.87 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $223.87 | Facility | None | $112.20 | $138.04 | $223.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $91.20 Typical High $218.78 | Professional | None | $79.43 | $91.20 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $177.83 Median $354.81 Typical High $851.14 | Facility | None | $177.83 | $354.81 | $851.14 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | None | $229.09 | $251.19 | $251.19 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $398.11 | Facility | None | $302.00 | $302.00 | $398.11 |
United Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $177.83 | Professional | None | $83.18 | $91.20 | $177.83 |
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 $54.95 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $21.88 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $21.88 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $13.18 | $13.18 |
Where Oregon sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 12th of 51
$178
HI $219DE $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.