How much rates vary
Facilitymedian $120 · 10th to 90th $87 to $141Professionalmedian $83 · 10th to 90th $49 to $155
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 $63.10 Median $83.18 Typical High $83.18 | Professional | None | $63.10 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $239.88 Typical High $302.00 | Professional | None | $107.15 | $239.88 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $104.71 Typical High $141.25 | Facility | None | $69.18 | $104.71 | $141.25 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $141.25 | Professional | None | $83.18 | $128.82 | $141.25 |
Pacific Source Setting Facility Modifier None Typical Low $102.33 Median $120.23 Typical High $138.04 | Facility | None | $102.33 | $120.23 | $138.04 |
Pacific Source Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $141.25 | Facility | None | $66.07 | $87.10 | $141.25 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $134.90 | Professional | None | $48.98 | $79.43 | $134.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $112.20 Median $223.87 Typical High $537.03 | Facility | None | $112.20 | $223.87 | $537.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | None | $144.54 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $229.09 | Facility | None | $169.82 | $169.82 | $229.09 |
United Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $102.33 | Professional | None | $47.86 | $52.48 | $102.33 |
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 $31.62 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $31.62 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $12.59 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $9.33 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.31 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $39.81 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $15.85 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $8.32 |
Where Oregon sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 11th of 51
$105
HI $174FL $48.98
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.