How much rates vary
Facilitymedian $490 · 10th to 90th $380 to $537Professionalmedian $309 · 10th to 90th $200 to $562
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 $263.03 Median $309.03 Typical High $309.03 | Professional | None | $263.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $1,000.00 Typical High $1,258.93 | Professional | None | $389.05 | $1,000.00 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $380.19 Typical High $512.86 | Facility | None | $263.03 | $380.19 | $512.86 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $512.86 | Professional | None | $309.03 | $467.74 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $537.03 | Facility | None | $398.11 | $489.78 | $537.03 |
Pacific Source Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | None | $398.11 | $501.19 | $501.19 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $512.86 | Facility | None | $269.15 | $309.03 | $512.86 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $489.78 | Professional | None | $79.43 | $199.53 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | None | $524.81 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Facility | None | $707.95 | $707.95 | $954.99 |
United Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $426.58 | Professional | None | $199.53 | $218.78 | $426.58 |
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 $131.83 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $52.48 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.30 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $30.90 |
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· 14th of 51
$398
HI $661DE $200
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.