How much rates vary
Facilitymedian $269 · 10th to 90th $204 to $295Professionalmedian $170 · 10th to 90th $117 to $316
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 $154.88 Median $169.82 Typical High $169.82 | Professional | None | $154.88 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $588.84 Typical High $741.31 | Professional | None | $213.80 | $588.84 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $213.80 Typical High $288.40 | Facility | None | $169.82 | $213.80 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $288.40 | Professional | None | $169.82 | $257.04 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $281.84 | Facility | None | $223.87 | $269.15 | $281.84 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $288.40 | Facility | None | $158.49 | $173.78 | $288.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $275.42 | Professional | None | $79.43 | $117.49 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $446.68 Typical High $1,096.48 | Facility | None | $223.87 | $446.68 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $316.23 | Professional | None | $288.40 | $316.23 | $316.23 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Facility | None | $416.87 | $416.87 | $562.34 |
United Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $251.19 | Professional | None | $114.82 | $128.82 | $251.19 |
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 $77.62 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $77.62 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $30.90 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $22.91 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.49 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $77.62 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $30.90 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $22.91 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.49 | $16.98 | $16.98 |
Where Oregon sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 15th of 51
$224
HI $468KS $107
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.