How much rates vary
Facilitymedian $1,023 · 10th to 90th $776 to $1,288Professionalmedian $661 · 10th to 90th $513 to $1,175
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 $616.60 Median $630.96 Typical High $676.08 | Professional | None | $616.60 | $630.96 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $2,344.23 Typical High $3,019.95 | Professional | None | $794.33 | $2,344.23 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $1,071.52 | Facility | None | $630.96 | $794.33 | $1,071.52 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,071.52 | Professional | None | $630.96 | $831.76 | $1,071.52 |
Pacific Source Setting Facility Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,148.15 | Facility | None | $831.76 | $1,023.29 | $1,148.15 |
Pacific Source Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | None | $1,047.13 | $1,047.13 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $707.95 Typical High $1,071.52 | Facility | None | $645.65 | $707.95 | $1,071.52 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $512.86 Typical High $1,023.29 | Professional | None | $79.43 | $512.86 | $1,023.29 |
Regence BlueShield Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $4,073.80 | Facility | None | $831.76 | $1,659.59 | $4,073.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,071.52 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,238.72 | Facility | None | $1,659.59 | $1,659.59 | $2,238.72 |
United Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $1,000.00 | Professional | None | $467.74 | $512.86 | $1,000.00 |
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 $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $123.03 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $63.10 |
Where Oregon sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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
$832
HI $1,738MS $513
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.