How much rates vary
Facilitymedian $676 · 10th to 90th $513 to $851Professionalmedian $417 · 10th to 90th $275 to $776
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 $354.81 Median $416.87 Typical High $416.87 | Professional | None | $354.81 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $1,348.96 Typical High $1,698.24 | Professional | None | $524.81 | $1,348.96 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $524.81 Typical High $707.95 | Facility | None | $354.81 | $524.81 | $707.95 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $707.95 | Professional | None | $416.87 | $645.65 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $776.25 | Facility | None | $549.54 | $676.08 | $776.25 |
Pacific Source Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $707.95 | Facility | None | $354.81 | $416.87 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $275.42 Typical High $676.08 | Professional | None | $79.43 | $275.42 | $676.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $2,691.53 | Facility | None | $549.54 | $1,096.48 | $2,691.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | None | $707.95 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Facility | None | $954.99 | $954.99 | $1,288.25 |
United Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $575.44 | Professional | None | $269.15 | $295.12 | $575.44 |
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 $177.83 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $52.48 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $208.93 | $208.93 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $83.18 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $41.69 |
Where Oregon sits
The same service costs 3.2 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· 13th of 51
$550
HI $871DE $275
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.