How much rates vary
Facilitymedian $245 · 10th to 90th $166 to $562Professionalmedian $269 · 10th to 90th $158 to $525
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 $181.97 Median $181.97 Typical High $223.87 | Professional | None | $181.97 | $181.97 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $371.54 Typical High $478.63 | Professional | None | $125.89 | $371.54 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $186.21 Typical High $562.34 | Facility | None | $169.82 | $186.21 | $562.34 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $323.59 | Professional | None | $158.49 | $173.78 | $323.59 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $501.19 | Facility | None | $165.96 | $245.47 | $501.19 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $562.34 | Facility | None | $102.33 | $186.21 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $281.84 Typical High $380.19 | Professional | None | $79.43 | $281.84 | $380.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $169.82 Median $758.58 Typical High $1,071.52 | Facility | None | $169.82 | $758.58 | $1,071.52 |
Regence BlueShield Setting Professional Modifier None Typical Low $186.21 Median $537.03 Typical High $575.44 | Professional | None | $186.21 | $537.03 | $575.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,479.11 | Facility | None | $1,122.02 | $1,122.02 | $1,479.11 |
United Setting Professional Modifier None Typical Low $100.00 Median $257.04 Typical High $407.38 | Professional | None | $100.00 | $257.04 | $407.38 |
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 $91.20 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $36.31 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $22.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $91.20 | $91.20 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $40.74 | Professional | 53 · Discontinued | $36.31 | $36.31 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $30.90 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $20.42 |
Where Oregon sits
The same service costs 3.0 times more in Hawaii than in Utah. 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· 47th of 51
$257
HI $661UT $224
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.