How much rates vary
Facilitymedian $324 · 10th to 90th $251 to $380Professionalmedian $229 · 10th to 90th $129 to $417
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 $169.82 Median $229.09 Typical High $229.09 | Professional | None | $169.82 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $645.65 Typical High $812.83 | Professional | None | $288.40 | $645.65 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $281.84 Typical High $380.19 | Facility | None | $186.21 | $281.84 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $380.19 | Professional | None | $229.09 | $346.74 | $380.19 |
Pacific Source Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $371.54 | Facility | None | $275.42 | $323.59 | $371.54 |
Pacific Source Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $380.19 | Facility | None | $173.78 | $229.09 | $380.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $363.08 | Professional | None | $79.43 | $128.82 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $302.00 Median $588.84 Typical High $1,445.44 | Facility | None | $302.00 | $588.84 | $1,445.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | None | $389.05 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $602.56 | Facility | None | $457.09 | $457.09 | $602.56 |
United Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $275.42 | Professional | None | $128.82 | $138.04 | $275.42 |
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 $83.18 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $83.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $33.88 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $25.12 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.98 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where Oregon sits
The same service costs 4.0 times more in Hawaii than in Florida. 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· 9th of 51
$282
HI $525FL $132
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.