How much rates vary
Facilitymedian $269 · 10th to 90th $200 to $347Professionalmedian $162 · 10th to 90th $105 to $302
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 $162.18 Typical High $169.82 | Professional | None | $154.88 | $162.18 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $562.34 Typical High $707.95 | Professional | None | $204.17 | $562.34 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $234.42 Typical High $275.42 | Facility | None | $162.18 | $234.42 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $302.00 | Professional | None | $162.18 | $245.47 | $302.00 |
Pacific Source Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $275.42 | Facility | None | $263.03 | $269.15 | $275.42 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $275.42 | Facility | None | $141.25 | $165.96 | $275.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $263.03 | Professional | None | $79.43 | $104.71 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $213.80 Median $426.58 Typical High $1,047.13 | Facility | None | $213.80 | $426.58 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | None | $275.42 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $537.03 | Facility | None | $398.11 | $398.11 | $537.03 |
United Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $239.88 | Professional | None | $114.82 | $123.03 | $239.88 |
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 $75.86 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $75.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $30.90 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.49 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $31.62 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.85 | $16.22 | $16.22 |
Where Oregon sits
The same service costs 2.2 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· 16th of 51
$214
HI $275DE $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.