How much rates vary
Facilitymedian $589 · 10th to 90th $468 to $661Professionalmedian $398 · 10th to 90th $295 to $724
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 $389.05 Typical High $389.05 | Professional | None | $354.81 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $1,380.38 Typical High $1,737.80 | Professional | None | $489.78 | $1,380.38 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $489.78 Typical High $660.69 | Facility | None | $389.05 | $489.78 | $660.69 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $660.69 | Professional | None | $389.05 | $602.56 | $660.69 |
Pacific Source Setting Facility Modifier None Typical Low $512.86 Median $630.96 Typical High $645.65 | Facility | None | $512.86 | $630.96 | $645.65 |
Pacific Source Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $794.33 | Professional | None | $645.65 | $645.65 | $794.33 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $660.69 | Facility | None | $398.11 | $398.11 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $295.12 Typical High $630.96 | Professional | None | $79.43 | $295.12 | $630.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $524.81 Median $1,023.29 Typical High $2,511.89 | Facility | None | $524.81 | $1,023.29 | $2,511.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | None | $660.69 | $724.44 | $724.44 |
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 $275.42 Median $295.12 Typical High $575.44 | Professional | None | $275.42 | $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 $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Where Oregon sits
The same service costs 3.7 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· 15th of 51
$513
HI $1,096DE $295
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.