How much rates vary
Facilitymedian $871 · 10th to 90th $676 to $977Professionalmedian $589 · 10th to 90th $427 to $1,000
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 $512.86 Median $549.54 Typical High $549.54 | Professional | None | $512.86 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,949.84 Typical High $2,511.89 | Professional | None | $691.83 | $1,949.84 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $912.01 | Facility | None | $537.03 | $676.08 | $912.01 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $912.01 | Professional | None | $549.54 | $831.76 | $912.01 |
Pacific Source Setting Facility Modifier None Typical Low $707.95 Median $870.96 Typical High $891.25 | Facility | None | $707.95 | $870.96 | $891.25 |
Pacific Source Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $588.84 Typical High $912.01 | Facility | None | $549.54 | $588.84 | $912.01 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $426.58 Typical High $870.96 | Professional | None | $79.43 | $426.58 | $870.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $724.44 Median $1,412.54 Typical High $3,467.37 | Facility | None | $724.44 | $1,412.54 | $3,467.37 |
Regence BlueShield Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | None | $933.25 | $1,000.00 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,862.09 | Facility | None | $1,412.54 | $1,412.54 | $1,862.09 |
United Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $851.14 | Professional | None | $398.11 | $426.58 | $851.14 |
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 $257.04 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $257.04 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $275.42 | $275.42 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Where Oregon sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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
$708
HI $1,175WV $427
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.