How much rates vary
Facilitymedian $513 · 10th to 90th $407 to $575Professionalmedian $331 · 10th to 90th $204 to $617
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 $257.04 Median $331.13 Typical High $331.13 | Professional | None | $257.04 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $1,000.00 Typical High $1,258.93 | Professional | None | $416.87 | $1,000.00 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $416.87 Typical High $562.34 | Facility | None | $275.42 | $416.87 | $562.34 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $562.34 | Professional | None | $331.13 | $501.19 | $562.34 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $512.86 Typical High $549.54 | Facility | None | $436.52 | $512.86 | $549.54 |
Pacific Source Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $562.34 | Facility | None | $275.42 | $331.13 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $204.17 Typical High $537.03 | Professional | None | $79.43 | $204.17 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $436.52 Median $870.96 Typical High $2,137.96 | Facility | None | $436.52 | $870.96 | $2,137.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $616.60 | Professional | None | $562.34 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $933.25 | Facility | None | $707.95 | $707.95 | $933.25 |
United Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $416.87 | Professional | None | $199.53 | $213.80 | $416.87 |
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 $128.82 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
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· 13th of 51
$437
HI $832DE $204
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.