How much rates vary
Facilitymedian $708 · 10th to 90th $550 to $813Professionalmedian $447 · 10th to 90th $288 to $813
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 $380.19 Median $446.68 Typical High $446.68 | Professional | None | $380.19 | $446.68 | $446.68 |
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 $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $1,479.11 Typical High $1,819.70 | Professional | None | $562.34 | $1,479.11 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $741.31 | Facility | None | $446.68 | $549.54 | $741.31 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $741.31 | Professional | None | $446.68 | $676.08 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $575.44 Median $707.95 Typical High $724.44 | Facility | None | $575.44 | $707.95 | $724.44 |
Pacific Source Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $812.83 | Professional | None | $575.44 | $724.44 | $812.83 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $446.68 Typical High $741.31 | Facility | None | $398.11 | $446.68 | $741.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $288.40 Typical High $707.95 | Professional | None | $79.43 | $288.40 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $588.84 Median $1,174.90 Typical High $2,818.38 | Facility | None | $588.84 | $1,174.90 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | None | $758.58 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,380.38 | Facility | None | $1,023.29 | $1,023.29 | $1,380.38 |
United Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $616.60 | Professional | None | $288.40 | $316.23 | $616.60 |
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 $190.55 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $190.55 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Where Oregon sits
The same service costs 2.8 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
$575
HI $794DE $288
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.