How much rates vary
Facilitymedian $372 · 10th to 90th $309 to $437Professionalmedian $257 · 10th to 90th $174 to $479
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 $208.93 Median $257.04 Typical High $257.04 | Professional | None | $208.93 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $812.83 Typical High $1,023.29 | Professional | None | $323.59 | $812.83 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $323.59 Typical High $436.52 | Facility | None | $223.87 | $323.59 | $436.52 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $436.52 | Professional | None | $257.04 | $398.11 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $426.58 | Facility | None | $338.84 | $380.19 | $426.58 |
Pacific Source Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $436.52 | Professional | None | $338.84 | $426.58 | $436.52 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $257.04 Typical High $436.52 | Facility | None | $223.87 | $257.04 | $436.52 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $416.87 | Professional | None | $79.43 | $177.83 | $416.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $338.84 Median $676.08 Typical High $1,659.59 | Facility | None | $338.84 | $676.08 | $1,659.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | None | $436.52 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $758.58 | Facility | None | $575.44 | $575.44 | $758.58 |
United Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $338.84 | Professional | None | $162.18 | $173.78 | $338.84 |
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 $104.71 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $41.69 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $31.62 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.89 | $25.70 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $51.29 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Where Oregon sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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
$339
HI $646TN $178
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.