How much rates vary
Facilitymedian $661 · 10th to 90th $457 to $871Professionalmedian $407 · 10th to 90th $309 to $759
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 $389.05 Median $407.38 Typical High $407.38 | Professional | None | $389.05 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $1,445.44 Typical High $1,819.70 | Professional | None | $512.86 | $1,445.44 | $1,819.70 |
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 $660.69 Typical High $707.95 | Professional | None | $407.38 | $660.69 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $602.56 Median $676.08 Typical High $707.95 | Facility | None | $602.56 | $676.08 | $707.95 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $436.52 Typical High $691.83 | Facility | None | $416.87 | $436.52 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $660.69 | Professional | None | $79.43 | $316.23 | $660.69 |
Regence BlueShield Setting Facility Modifier None Typical Low $549.54 Median $1,071.52 Typical High $2,630.27 | Facility | None | $549.54 | $1,071.52 | $2,630.27 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | None | $691.83 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,348.96 | Facility | None | $1,000.00 | $1,000.00 | $1,348.96 |
United Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $602.56 | Professional | None | $288.40 | $309.03 | $602.56 |
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 $194.98 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $199.53 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $79.43 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $40.74 |
Where Oregon sits
The same service costs 2.3 times more in Montana than in Delaware. 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· 11th of 51
$589
MT $741DE $316
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.