How much rates vary
Facilitymedian $288 · 10th to 90th $229 to $331Professionalmedian $195 · 10th to 90th $126 to $363
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 $165.96 Median $194.98 Typical High $194.98 | Professional | None | $165.96 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $630.96 Typical High $794.33 | Professional | None | $245.47 | $630.96 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $245.47 Typical High $331.13 | Facility | None | $169.82 | $245.47 | $331.13 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $331.13 | Professional | None | $194.98 | $302.00 | $331.13 |
Pacific Source Setting Facility Modifier None Typical Low $257.04 Median $288.40 Typical High $323.59 | Facility | None | $257.04 | $288.40 | $323.59 |
Pacific Source Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $199.53 Typical High $331.13 | Facility | None | $169.82 | $199.53 | $331.13 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $316.23 | Professional | None | $79.43 | $125.89 | $316.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $263.03 Median $512.86 Typical High $1,258.93 | Facility | None | $263.03 | $512.86 | $1,258.93 |
Regence BlueShield Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | None | $331.13 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Facility | None | $446.68 | $446.68 | $588.84 |
United Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $269.15 | Professional | None | $123.03 | $138.04 | $269.15 |
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 $81.28 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $33.11 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $24.55 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.60 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where Oregon sits
The same service costs 4.7 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· 13th of 51
$257
HI $589DE $126
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.