How much rates vary
Facilitymedian $204 · 10th to 90th $138 to $427Professionalmedian $219 · 10th to 90th $132 to $427
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 Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $295.12 | Professional | None | $144.54 | $144.54 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | RR · Rental | $25.70 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $309.03 Typical High $398.11 | Professional | None | $104.71 | $309.03 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $154.88 Typical High $426.58 | Facility | None | $141.25 | $154.88 | $426.58 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $338.84 | Professional | None | $134.90 | $144.54 | $338.84 |
Pacific Source Setting Facility Modifier None Typical Low $138.04 Median $204.17 Typical High $398.11 | Facility | None | $138.04 | $204.17 | $398.11 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $154.88 Typical High $426.58 | Facility | None | $85.11 | $154.88 | $426.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $302.00 | Professional | None | $79.43 | $218.78 | $302.00 |
Providence Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | RR · Rental | $25.70 | $25.70 | $25.70 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $630.96 Typical High $812.83 | Facility | None | $141.25 | $630.96 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $426.58 Typical High $446.68 | Professional | None | $154.88 | $426.58 | $446.68 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $794.33 | Facility | None | $588.84 | $588.84 | $794.33 |
United Setting Professional Modifier None Typical Low $81.28 Median $218.78 Typical High $346.74 | Professional | None | $81.28 | $218.78 | $346.74 |
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 $72.44 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $72.44 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | 53 · Discontinued | $28.84 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $19.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 52 · Reduced service | $72.44 | $72.44 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $32.36 | Professional | 53 · Discontinued | $28.84 | $28.84 | $32.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $16.22 |
Where Oregon sits
The same service costs 2.6 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· 46th of 51
$219
HI $490UT $191
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.