How much rates vary
Facilitymedian $120 · 10th to 90th $100 to $148Professionalmedian $83 · 10th to 90th $56 to $151
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 $69.18 Median $81.28 Typical High $81.28 | Professional | None | $69.18 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None | $61.66 | $61.66 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $263.03 Typical High $331.13 | Professional | None | $102.33 | $263.03 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $138.04 | Facility | None | $72.44 | $102.33 | $138.04 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $138.04 | Professional | None | $81.28 | $125.89 | $138.04 |
Pacific Source Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $134.90 | Facility | None | $107.15 | $131.83 | $134.90 |
Pacific Source Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $85.11 Typical High $138.04 | Facility | None | $74.13 | $85.11 | $138.04 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $131.83 | Professional | None | $61.66 | $79.43 | $131.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $109.65 Median $213.80 Typical High $524.81 | Facility | None | $109.65 | $213.80 | $524.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | None | $138.04 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $245.47 | Facility | None | $186.21 | $186.21 | $245.47 |
United Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $112.20 | Professional | None | $51.29 | $56.23 | $112.20 |
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 $33.88 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $33.88 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $13.80 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $10.23 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.92 | $8.13 | $8.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $33.88 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $13.80 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $10.23 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.92 | $8.13 | $8.13 |
Where Oregon sits
The same service costs 2.2 times more in Hawaii than in Alabama. 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
$107
HI $138AL $61.66
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.