How much rates vary
Facilitymedian $251 · 10th to 90th $195 to $282Professionalmedian $155 · 10th to 90th $100 to $288
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 $120.23 Median $154.88 Typical High $154.88 | Professional | None | $120.23 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $467.74 Typical High $588.84 | Professional | None | $194.98 | $467.74 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $263.03 | Facility | None | $147.91 | $194.98 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $263.03 | Professional | None | $154.88 | $239.88 | $263.03 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $257.04 | Facility | None | $204.17 | $251.19 | $257.04 |
Pacific Source Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $158.49 Typical High $263.03 | Facility | None | $144.54 | $158.49 | $263.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $251.19 | Professional | None | $79.43 | $104.71 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $208.93 Median $407.38 Typical High $1,000.00 | Facility | None | $208.93 | $407.38 | $1,000.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | None | $263.03 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $436.52 | Facility | None | $323.59 | $323.59 | $436.52 |
United Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $194.98 | Professional | None | $91.20 | $100.00 | $194.98 |
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 $60.26 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.99 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $60.26 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.99 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $15.49 |
Where Oregon sits
The same service costs 2.5 times more in Montana than in Florida. 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· 9th of 51
$204
MT $263FL $105
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.