How much rates vary
Facilitymedian $417 · 10th to 90th $316 to $490Professionalmedian $257 · 10th to 90th $166 to $479
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 $218.78 Median $257.04 Typical High $257.04 | Professional | None | $218.78 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $851.14 Typical High $1,071.52 | Professional | None | $323.59 | $851.14 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $436.52 | Facility | None | $218.78 | $323.59 | $436.52 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $436.52 | Professional | None | $257.04 | $398.11 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $338.84 Median $416.87 Typical High $446.68 | Facility | None | $338.84 | $416.87 | $446.68 |
Pacific Source Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $489.78 | Professional | None | $446.68 | $446.68 | $489.78 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $436.52 | Facility | None | $218.78 | $263.03 | $436.52 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $416.87 | Professional | None | $79.43 | $165.96 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $346.74 Median $676.08 Typical High $1,659.59 | Facility | None | $346.74 | $676.08 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | None | $436.52 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $794.33 | Facility | None | $602.56 | $602.56 | $794.33 |
United Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $354.81 | Professional | None | $169.82 | $181.97 | $354.81 |
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 $109.65 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $43.65 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $33.11 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.88 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $51.29 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Where Oregon sits
The same service costs 2.7 times more in Montana 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· 12th of 51
$339
MT $457DE $170
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.