How much rates vary
Facilitymedian $81 · 10th to 90th $65 to $89Professionalmedian $65 · 10th to 90th $41 to $95
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 $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $181.97 Typical High $239.88 | Professional | None | $66.07 | $181.97 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $51.29 Median $64.57 Typical High $87.10 | Facility | None | $51.29 | $64.57 | $87.10 |
Moda Health Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $87.10 | Professional | None | $51.29 | $79.43 | $87.10 |
Pacific Source Setting Facility Modifier None Typical Low $67.61 Median $81.28 Typical High $85.11 | Facility | None | $67.61 | $81.28 | $85.11 |
Pacific Source Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $102.33 | Professional | None | $77.62 | $81.28 | $102.33 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $61.66 Typical High $87.10 | Facility | None | $53.70 | $61.66 | $87.10 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $83.18 | Professional | None | $44.67 | $70.79 | $83.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $69.18 Median $134.90 Typical High $331.13 | Facility | None | $69.18 | $134.90 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | None | $89.13 | $95.50 | $95.50 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $177.83 | Facility | None | $131.83 | $131.83 | $177.83 |
United Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $79.43 | Professional | None | $37.15 | $40.74 | $79.43 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.59 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Where Oregon sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 18th of 51
$70.79
HI $112AZ $44.67
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.