How much rates vary
Facilitymedian $102 · 10th to 90th $85 to $126Professionalmedian $79 · 10th to 90th $49 to $129
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 $61.66 Median $69.18 Typical High $69.18 | Professional | None | $61.66 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $83.18 | Professional | None | $61.66 | $61.66 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $223.87 Typical High $281.84 | Professional | None | $87.10 | $223.87 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $87.10 Typical High $117.49 | Facility | None | $69.18 | $87.10 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $117.49 | Professional | None | $69.18 | $107.15 | $117.49 |
Pacific Source Setting Facility Modifier None Typical Low $91.20 Median $107.15 Typical High $114.82 | Facility | None | $91.20 | $107.15 | $114.82 |
Pacific Source Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $117.49 | Facility | None | $70.79 | $83.18 | $117.49 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $112.20 | Professional | None | $61.66 | $79.43 | $112.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $181.97 Typical High $446.68 | Facility | None | $93.33 | $181.97 | $446.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | None | $117.49 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Facility | None | $158.49 | $158.49 | $213.80 |
United Setting Professional Modifier None Typical Low $43.65 Median $48.98 Typical High $95.50 | Professional | None | $43.65 | $48.98 | $95.50 |
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 $30.90 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $30.90 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $12.59 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.33 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.17 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Where Oregon sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 17th of 51
$91.20
HI $186DC $52.48
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.