How much rates vary
Facilitymedian $85 · 10th to 90th $65 to $95Professionalmedian $65 · 10th to 90th $40 to $98
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 $47.86 Median $52.48 Typical High $52.48 | Professional | None | $47.86 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $186.21 Typical High $229.09 | Professional | None | $70.79 | $186.21 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $87.10 | Facility | None | $52.48 | $69.18 | $87.10 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $89.13 | Professional | None | $52.48 | $75.86 | $89.13 |
Pacific Source Setting Facility Modifier None Typical Low $69.18 Median $85.11 Typical High $89.13 | Facility | None | $69.18 | $85.11 | $89.13 |
Pacific Source Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $56.23 Typical High $89.13 | Facility | None | $53.70 | $56.23 | $89.13 |
Providence Setting Professional Modifier None Typical Low $40.74 Median $70.79 Typical High $85.11 | Professional | None | $40.74 | $70.79 | $85.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $69.18 Median $138.04 Typical High $338.84 | Facility | None | $69.18 | $138.04 | $338.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | None | $89.13 | $97.72 | $97.72 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Facility | None | $128.82 | $128.82 | $173.78 |
United Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $77.62 | Professional | None | $36.31 | $39.81 | $77.62 |
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 $23.99 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $23.99 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $9.55 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.08 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.79 | $5.25 | $5.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $25.70 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.23 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.13 | $5.25 | $5.25 |
Where Oregon sits
The same service costs 3.1 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· 14th of 51
$70.79
HI $93.33KS $30.20
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.