How much rates vary
Facilitymedian $363 · 10th to 90th $275 to $407Professionalmedian $224 · 10th to 90th $155 to $417
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 $204.17 Median $223.87 Typical High $223.87 | Professional | None | $204.17 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | None | $154.88 | $154.88 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $776.25 Typical High $977.24 | Professional | None | $302.00 | $776.25 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $316.23 Typical High $380.19 | Facility | None | $223.87 | $316.23 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $389.05 | Professional | None | $213.80 | $288.40 | $389.05 |
Pacific Source Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $380.19 | Facility | None | $295.12 | $363.08 | $380.19 |
Pacific Source Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $229.09 Typical High $380.19 | Facility | None | $208.93 | $229.09 | $380.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $363.08 | Professional | None | $79.43 | $154.88 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $295.12 Median $588.84 Typical High $1,445.44 | Facility | None | $295.12 | $588.84 | $1,445.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | None | $380.19 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $741.31 | Facility | None | $549.54 | $549.54 | $741.31 |
United Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $331.13 | Professional | None | $154.88 | $169.82 | $331.13 |
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 $102.33 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $40.74 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $104.71 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $43.65 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.88 | $22.39 | $22.39 |
Where Oregon sits
The same service costs 2.4 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
$295
HI $380DE $158
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.