How much rates vary
Facilitymedian $676 · 10th to 90th $479 to $759Professionalmedian $457 · 10th to 90th $339 to $776
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 Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | None | $407.38 | $407.38 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | None | $338.84 | $338.84 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $1,548.82 Typical High $1,995.26 | Professional | None | $524.81 | $1,548.82 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $691.83 | Facility | None | $407.38 | $588.84 | $691.83 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $724.44 | Professional | None | $407.38 | $549.54 | $724.44 |
Pacific Source Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $691.83 | Facility | None | $549.54 | $676.08 | $691.83 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $457.09 Typical High $691.83 | Facility | None | $426.58 | $457.09 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $338.84 Typical High $676.08 | Professional | None | $79.43 | $338.84 | $676.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $2,630.27 | Facility | None | $549.54 | $1,096.48 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | None | $707.95 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,479.11 | Facility | None | $1,122.02 | $1,122.02 | $1,479.11 |
United Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $676.08 | Professional | None | $309.03 | $338.84 | $676.08 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | 53 · Discontinued | $81.28 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 19th of 51
$550
HI $871NH $339
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.