How much rates vary
Facilitymedian $102 · 10th to 90th $65 to $135Professionalmedian $63 · 10th to 90th $39 to $117
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 $53.70 Median $63.10 Typical High $63.10 | Professional | None | $53.70 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $251.19 | Professional | None | $79.43 | $199.53 | $251.19 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $107.15 | Facility | None | $63.10 | $89.13 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $63.10 | Professional | None | $53.70 | $63.10 | $63.10 |
Pacific Source Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $104.71 | Facility | None | $85.11 | $102.33 | $104.71 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $107.15 | Facility | None | $53.70 | $64.57 | $107.15 |
Providence Setting Professional Modifier None Typical Low $38.90 Median $79.43 Typical High $102.33 | Professional | None | $38.90 | $79.43 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $83.18 Median $165.96 Typical High $407.38 | Facility | None | $83.18 | $165.96 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $186.21 | Facility | None | $141.25 | $141.25 | $186.21 |
United Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $85.11 | Professional | None | $40.74 | $42.66 | $85.11 |
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 $26.92 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $26.92 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $10.72 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.13 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.37 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $28.84 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $11.75 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.71 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.75 | $6.31 | $6.31 |
Where Oregon sits
The same service costs 3.3 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· 14th of 51
$79.43
HI $135DE $40.74
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.