How much rates vary
Facilitymedian $234 · 10th to 90th $195 to $316Professionalmedian $178 · 10th to 90th $155 to $324
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 $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $446.68 Typical High $575.44 | Professional | None | $154.88 | $446.68 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $204.17 Typical High $316.23 | Facility | None | $158.49 | $204.17 | $316.23 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $275.42 | Professional | None | $158.49 | $194.98 | $275.42 |
Pacific Source Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $302.00 | Facility | None | $199.53 | $263.03 | $302.00 |
Pacific Source Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $302.00 | Professional | None | $181.97 | $199.53 | $302.00 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $213.80 Typical High $316.23 | Facility | None | $125.89 | $213.80 | $316.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $158.49 Typical High $295.12 | Professional | None | $79.43 | $158.49 | $295.12 |
Regence BlueShield Setting Facility Modifier None Typical Low $199.53 Median $575.44 Typical High $812.83 | Facility | None | $199.53 | $575.44 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $338.84 | Professional | None | $223.87 | $323.59 | $338.84 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Facility | None | $489.78 | $489.78 | $660.69 |
United Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $245.47 | Professional | None | $117.49 | $162.18 | $245.47 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Oregon sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 25th of 51
$200
HI $437UT $151
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.