How much rates vary
Facilitymedian $331 · 10th to 90th $257 to $417Professionalmedian $229 · 10th to 90th $151 to $427
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 $229.09 Typical High $229.09 | Professional | None | $181.97 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $691.83 Typical High $870.96 | Professional | None | $288.40 | $691.83 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $389.05 | Facility | None | $204.17 | $288.40 | $389.05 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $389.05 | Professional | None | $229.09 | $354.81 | $389.05 |
Pacific Source Setting Facility Modifier None Typical Low $295.12 Median $346.74 Typical High $380.19 | Facility | None | $295.12 | $346.74 | $380.19 |
Pacific Source Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $389.05 | Facility | None | $204.17 | $234.42 | $389.05 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $158.49 Typical High $371.54 | Professional | None | $79.43 | $158.49 | $371.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $309.03 Median $602.56 Typical High $1,479.11 | Facility | None | $309.03 | $602.56 | $1,479.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | None | $389.05 | $426.58 | $426.58 |
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 $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 $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $91.20 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $97.72 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.50 | $22.91 | $22.91 |
Where Oregon sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 10th of 51
$302
HI $525WV $158
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.