How much rates vary
Facilitymedian $324 · 10th to 90th $251 to $372Professionalmedian $200 · 10th to 90th $138 to $380
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 $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $707.95 Typical High $891.25 | Professional | None | $257.04 | $707.95 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $251.19 Typical High $338.84 | Facility | None | $199.53 | $251.19 | $338.84 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $338.84 | Professional | None | $199.53 | $309.03 | $338.84 |
Pacific Source Setting Facility Modifier None Typical Low $263.03 Median $323.59 Typical High $338.84 | Facility | None | $263.03 | $323.59 | $338.84 |
Pacific Source Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $208.93 Typical High $338.84 | Facility | None | $190.55 | $208.93 | $338.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $323.59 | Professional | None | $79.43 | $138.04 | $323.59 |
Regence BlueShield Setting Facility Modifier None Typical Low $269.15 Median $537.03 Typical High $1,288.25 | Facility | None | $269.15 | $537.03 | $1,288.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | None | $346.74 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $660.69 | Facility | None | $501.19 | $501.19 | $660.69 |
United Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $295.12 | Professional | None | $138.04 | $151.36 | $295.12 |
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 $91.20 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $36.31 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $27.54 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $39.81 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $19.95 |
Where Oregon sits
The same service costs 2.7 times more in Hawaii 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· 17th of 51
$263
HI $372DE $138
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.