How much rates vary
Facilitymedian $537 · 10th to 90th $407 to $589Professionalmedian $339 · 10th to 90th $245 to $617
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 $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $1,202.26 Typical High $1,548.82 | Professional | None | $416.87 | $1,202.26 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $549.54 | Facility | None | $323.59 | $407.38 | $549.54 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $549.54 | Professional | None | $323.59 | $501.19 | $549.54 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $537.03 Typical High $588.84 | Facility | None | $436.52 | $537.03 | $588.84 |
Pacific Source Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $549.54 | Professional | None | $436.52 | $436.52 | $549.54 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $346.74 Typical High $549.54 | Facility | None | $338.84 | $346.74 | $549.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $537.03 | Professional | None | $79.43 | $245.47 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $436.52 Median $870.96 Typical High $2,089.30 | Facility | None | $436.52 | $870.96 | $2,089.30 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | None | $562.34 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Facility | None | $870.96 | $870.96 | $1,174.90 |
United Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $524.81 | Professional | None | $245.47 | $269.15 | $524.81 |
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 $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
Where Oregon sits
The same service costs 4.2 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
$437
HI $1,023DE $245
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.