How much rates vary
Facilitymedian $98 · 10th to 90th $76 to $107Professionalmedian $74 · 10th to 90th $49 to $112
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 $58.88 Median $60.26 Typical High $60.26 | Professional | None | $58.88 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $218.78 Typical High $281.84 | Professional | None | $77.62 | $218.78 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $102.33 | Facility | None | $60.26 | $75.86 | $102.33 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $102.33 | Professional | None | $60.26 | $93.33 | $102.33 |
Pacific Source Setting Facility Modifier None Typical Low $79.43 Median $97.72 Typical High $100.00 | Facility | None | $79.43 | $97.72 | $100.00 |
Pacific Source Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $112.20 | Professional | None | $97.72 | $100.00 | $112.20 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $72.44 Typical High $102.33 | Facility | None | $63.10 | $72.44 | $102.33 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $97.72 | Professional | None | $53.70 | $79.43 | $97.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $81.28 Median $162.18 Typical High $389.05 | Facility | None | $81.28 | $162.18 | $389.05 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | None | $104.71 | $112.20 | $112.20 |
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 $29.51 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $29.51 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $11.75 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.89 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $29.51 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $11.75 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.89 | $6.03 | $6.03 |
Where Oregon sits
The same service costs 3.2 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· 15th of 51
$79.43
HI $166FL $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.