How much rates vary
Facilitymedian $100 · 10th to 90th $79 to $115Professionalmedian $71 · 10th to 90th $50 to $123
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 $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $234.42 Typical High $295.12 | Professional | None | $85.11 | $234.42 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $112.20 | Facility | None | $66.07 | $83.18 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $114.82 | Professional | None | $66.07 | $85.11 | $114.82 |
Pacific Source Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $109.65 | Facility | None | $87.10 | $100.00 | $109.65 |
Pacific Source Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $69.18 Typical High $112.20 | Facility | None | $67.61 | $69.18 | $112.20 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $107.15 | Professional | None | $50.12 | $79.43 | $107.15 |
Regence BlueShield Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $426.58 | Facility | None | $89.13 | $177.83 | $426.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | None | $114.82 | $123.03 | $123.03 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $218.78 | Facility | None | $165.96 | $165.96 | $218.78 |
United Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $97.72 | Professional | None | $45.71 | $50.12 | $97.72 |
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 $30.20 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.61 | $6.61 |
Where Oregon sits
The same service costs 4.1 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
$87.10
HI $209DE $51.29
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.