How much rates vary
Facilitymedian $372 · 10th to 90th $245 to $417Professionalmedian $245 · 10th to 90th $182 to $427
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 $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None | $181.97 | $181.97 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $870.96 Typical High $1,122.02 | Professional | None | $295.12 | $870.96 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $389.05 | Facility | None | $229.09 | $288.40 | $389.05 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $389.05 | Professional | None | $234.42 | $354.81 | $389.05 |
Pacific Source Setting Facility Modifier None Typical Low $302.00 Median $371.54 Typical High $380.19 | Facility | None | $302.00 | $371.54 | $380.19 |
Pacific Source Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Providence Setting Facility Modifier None Typical Low $234.42 Median $245.47 Typical High $389.05 | Facility | None | $234.42 | $245.47 | $389.05 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $371.54 | Professional | None | $79.43 | $181.97 | $371.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $309.03 Median $602.56 Typical High $1,479.11 | Facility | None | $309.03 | $602.56 | $1,479.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | None | $398.11 | $426.58 | $426.58 |
United Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Facility | None | $616.60 | $616.60 | $831.76 |
United Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $371.54 | Professional | None | $177.83 | $190.55 | $371.54 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $45.71 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
Where Oregon sits
The same service costs 2.5 times more in Kansas 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· 19th of 51
$302
KS $457FL $186
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.