How much rates vary
Facilitymedian $166 · 10th to 90th $132 to $186Professionalmedian $105 · 10th to 90th $71 to $200
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 $85.11 Median $104.71 Typical High $104.71 | Professional | None | $85.11 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | None | $74.13 | $74.13 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $331.13 Typical High $407.38 | Professional | None | $134.90 | $331.13 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $134.90 Typical High $177.83 | Facility | None | $95.50 | $134.90 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $177.83 | Professional | None | $93.33 | $138.04 | $177.83 |
Pacific Source Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $177.83 | Facility | None | $141.25 | $165.96 | $177.83 |
Pacific Source Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $177.83 | Facility | None | $95.50 | $109.65 | $177.83 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $173.78 | Professional | None | $74.13 | $79.43 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $281.84 Typical High $676.08 | Facility | None | $141.25 | $281.84 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $309.03 | Facility | None | $229.09 | $229.09 | $309.03 |
United Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $138.04 | Professional | None | $64.57 | $70.79 | $138.04 |
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 $42.66 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $42.66 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.98 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $12.59 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.51 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $42.66 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.98 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $12.59 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.51 | $10.47 | $10.47 |
Where Oregon sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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· 13th of 51
$141
HI $214NJ $74.13
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.