How much rates vary
Facilitymedian $347 · 10th to 90th $269 to $437Professionalmedian $214 · 10th to 90th $148 to $398
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 $194.98 Median $213.80 Typical High $213.80 | Professional | None | $194.98 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $758.58 Typical High $954.99 | Professional | None | $269.15 | $758.58 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $269.15 Typical High $363.08 | Facility | None | $194.98 | $269.15 | $363.08 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $363.08 | Professional | None | $213.80 | $331.13 | $363.08 |
Pacific Source Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $436.52 | Facility | None | $281.84 | $346.74 | $436.52 |
Pacific Source Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $389.05 | Professional | None | $281.84 | $354.81 | $389.05 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $363.08 | Facility | None | $194.98 | $218.78 | $363.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $346.74 | Professional | None | $79.43 | $147.91 | $346.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $288.40 Median $562.34 Typical High $1,380.38 | Facility | None | $288.40 | $562.34 | $1,380.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | None | $363.08 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $707.95 | Facility | None | $537.03 | $537.03 | $707.95 |
United Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $316.23 | Professional | None | $151.36 | $162.18 | $316.23 |
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 $97.72 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $29.51 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.50 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $107.15 | $107.15 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $43.65 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $21.38 |
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· 13th of 51
$282
HI $501DE $151
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.