How much rates vary
Facilitymedian $166 · 10th to 90th $132 to $191Professionalmedian $115 · 10th to 90th $72 to $209
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 $95.50 Median $114.82 Typical High $114.82 | Professional | None | $95.50 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $371.54 Typical High $467.74 | Professional | None | $144.54 | $371.54 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $141.25 Typical High $190.55 | Facility | None | $95.50 | $141.25 | $190.55 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $190.55 | Professional | None | $114.82 | $173.78 | $190.55 |
Pacific Source Setting Facility Modifier None Typical Low $147.91 Median $169.82 Typical High $186.21 | Facility | None | $147.91 | $169.82 | $186.21 |
Pacific Source Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $114.82 Typical High $190.55 | Facility | None | $95.50 | $114.82 | $190.55 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $181.97 | Professional | None | $72.44 | $79.43 | $181.97 |
Regence BlueShield Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $724.44 | Facility | None | $151.36 | $295.12 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | None | $194.98 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $346.74 | Facility | None | $263.03 | $263.03 | $346.74 |
United Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $154.88 | Professional | None | $74.13 | $79.43 | $154.88 |
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 $47.86 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $47.86 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $19.05 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $14.45 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.55 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.91 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Where Oregon sits
The same service costs 4.1 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
$148
HI $295DE $72.44
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.