How much rates vary
Facilitymedian $87 · 10th to 90th $69 to $98Professionalmedian $71 · 10th to 90th $44 to $105
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 $52.48 Median $56.23 Typical High $56.23 | Professional | None | $52.48 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $199.53 Typical High $257.04 | Professional | None | $70.79 | $199.53 | $257.04 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $70.79 Typical High $95.50 | Facility | None | $56.23 | $70.79 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | None | $56.23 | $87.10 | $95.50 |
Pacific Source Setting Facility Modifier None Typical Low $74.13 Median $91.20 Typical High $93.33 | Facility | None | $74.13 | $91.20 | $93.33 |
Pacific Source Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $63.10 Typical High $95.50 | Facility | None | $57.54 | $63.10 | $95.50 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $91.20 | Professional | None | $45.71 | $77.62 | $91.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $363.08 | Facility | None | $75.86 | $147.91 | $363.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | None | $95.50 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $190.55 | Facility | None | $141.25 | $141.25 | $190.55 |
United Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $85.11 | Professional | None | $39.81 | $43.65 | $85.11 |
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 $26.30 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $26.30 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.47 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.94 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.25 | $5.62 | $5.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $26.92 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.96 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.13 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.37 | $5.62 | $5.62 |
Where Oregon sits
The same service costs 3.2 times more in Hawaii than in New Jersey. 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
$77.62
HI $148NJ $45.71
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.