How much rates vary
Facilitymedian $107 · 10th to 90th $81 to $123Professionalmedian $72 · 10th to 90th $46 to $123
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 $54.95 Median $66.07 Typical High $66.07 | Professional | None | $54.95 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $213.80 Typical High $269.15 | Professional | None | $83.18 | $213.80 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $58.88 Median $83.18 Typical High $112.20 | Facility | None | $58.88 | $83.18 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $112.20 | Professional | None | $66.07 | $89.13 | $112.20 |
Pacific Source Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $120.23 | Facility | None | $87.10 | $107.15 | $120.23 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $67.61 Typical High $112.20 | Facility | None | $58.88 | $67.61 | $112.20 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $107.15 | Professional | None | $45.71 | $79.43 | $107.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $87.10 Median $173.78 Typical High $426.58 | Facility | None | $87.10 | $173.78 | $426.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | None | $112.20 | $123.03 | $123.03 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $199.53 | Facility | None | $151.36 | $151.36 | $199.53 |
United Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $89.13 | Professional | None | $41.69 | $45.71 | $89.13 |
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 $27.54 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $27.54 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $10.96 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $8.32 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.50 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $28.18 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $11.22 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $8.51 | $9.77 | $9.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.62 | $6.61 | $6.61 |
Where Oregon sits
The same service costs 4.3 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· 12th of 51
$87.10
HI $195DE $45.71
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.