How much rates vary
Facilitymedian $191 · 10th to 90th $145 to $240Professionalmedian $123 · 10th to 90th $89 to $219
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 $117.49 Median $120.23 Typical High $120.23 | Professional | None | $117.49 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $446.68 Typical High $575.44 | Professional | None | $151.36 | $446.68 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $199.53 | Facility | None | $117.49 | $147.91 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $199.53 | Professional | None | $120.23 | $181.97 | $199.53 |
Pacific Source Setting Facility Modifier None Typical Low $154.88 Median $190.55 Typical High $239.88 | Facility | None | $154.88 | $190.55 | $239.88 |
Pacific Source Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | None | $194.98 | $194.98 | $239.88 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $123.03 Typical High $199.53 | Facility | None | $117.49 | $123.03 | $199.53 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $190.55 | Professional | None | $79.43 | $89.13 | $190.55 |
Regence BlueShield Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $758.58 | Facility | None | $158.49 | $309.03 | $758.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | None | $204.17 | $218.78 | $218.78 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $426.58 | Facility | None | $316.23 | $316.23 | $426.58 |
United Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $190.55 | Professional | None | $91.20 | $97.72 | $190.55 |
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 $58.88 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.44 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.75 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $58.88 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where Oregon sits
The same service costs 3.0 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· 16th of 51
$155
HI $275DE $93.33
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.