How much rates vary
Facilitymedian $288 · 10th to 90th $224 to $389Professionalmedian $191 · 10th to 90th $138 to $331
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 $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $660.69 Typical High $851.14 | Professional | None | $223.87 | $660.69 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $251.19 Typical High $302.00 | Facility | None | $177.83 | $251.19 | $302.00 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $302.00 | Professional | None | $177.83 | $275.42 | $302.00 |
Pacific Source Setting Facility Modifier None Typical Low $234.42 Median $288.40 Typical High $380.19 | Facility | None | $234.42 | $288.40 | $380.19 |
Pacific Source Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $190.55 Typical High $302.00 | Facility | None | $177.83 | $190.55 | $302.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $288.40 | Professional | None | $79.43 | $138.04 | $288.40 |
Regence BlueShield Setting Facility Modifier None Typical Low $239.88 Median $467.74 Typical High $1,148.15 | Facility | None | $239.88 | $467.74 | $1,148.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | None | $302.00 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $645.65 | Facility | None | $478.63 | $478.63 | $645.65 |
United Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $288.40 | Professional | None | $134.90 | $147.91 | $288.40 |
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 $89.13 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $89.13 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $35.48 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $17.78 |
Where Oregon sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 16th of 51
$234
HI $479FL $138
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.