How much rates vary
Facilitymedian $537 · 10th to 90th $437 to $661Professionalmedian $363 · 10th to 90th $219 to $676
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 $288.40 Median $363.08 Typical High $363.08 | Professional | None | $288.40 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $1,096.48 Typical High $1,380.38 | Professional | None | $457.09 | $1,096.48 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $616.60 | Facility | None | $331.13 | $457.09 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $616.60 | Professional | None | $363.08 | $562.34 | $616.60 |
Pacific Source Setting Facility Modifier None Typical Low $478.63 Median $537.03 Typical High $602.56 | Facility | None | $478.63 | $537.03 | $602.56 |
Pacific Source Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $630.96 | Professional | None | $478.63 | $602.56 | $630.96 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $371.54 Typical High $616.60 | Facility | None | $295.12 | $371.54 | $616.60 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $588.84 | Professional | None | $79.43 | $218.78 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $2,344.23 | Facility | None | $478.63 | $954.99 | $2,344.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,047.13 | Facility | None | $776.25 | $776.25 | $1,047.13 |
United Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $467.74 | Professional | None | $213.80 | $239.88 | $467.74 |
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 $144.54 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $57.54 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $42.66 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $28.84 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $144.54 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $57.54 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $43.65 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $28.84 | $36.31 | $36.31 |
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· 12th of 51
$479
HI $912DE $219
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.