How much rates vary
Facilitymedian $141 · 10th to 90th $95 to $295Professionalmedian $155 · 10th to 90th $93 to $295
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 $100.00 Median $100.00 Typical High $131.83 | Professional | None | $100.00 | $100.00 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $213.80 Typical High $275.42 | Professional | None | $74.13 | $213.80 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $104.71 Typical High $295.12 | Facility | None | $97.72 | $104.71 | $295.12 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $194.98 | Professional | None | $93.33 | $100.00 | $194.98 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $141.25 Typical High $275.42 | Facility | None | $95.50 | $141.25 | $275.42 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $107.15 Typical High $295.12 | Facility | None | $60.26 | $107.15 | $295.12 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $251.19 | Professional | None | $79.43 | $154.88 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $436.52 Typical High $562.34 | Facility | None | $97.72 | $436.52 | $562.34 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $295.12 Typical High $309.03 | Professional | None | $107.15 | $295.12 | $309.03 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $549.54 | Facility | None | $416.87 | $416.87 | $549.54 |
United Setting Professional Modifier None Typical Low $57.54 Median $154.88 Typical High $239.88 | Professional | None | $57.54 | $154.88 | $239.88 |
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 $50.12 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $50.12 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $26.30 | Professional | 53 · Discontinued | $19.95 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $13.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | 52 · Reduced service | $50.12 | $50.12 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $19.95 | $19.95 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $11.22 |
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
$155
HI $347UT $132
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.