How much rates vary
Facilitymedian $891 · 10th to 90th $676 to $955Professionalmedian $562 · 10th to 90th $347 to $1,023
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 $416.87 Median $562.34 Typical High $562.34 | Professional | None | $416.87 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,621.81 Typical High $2,041.74 | Professional | None | $707.95 | $1,621.81 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $691.83 Typical High $933.25 | Facility | None | $467.74 | $691.83 | $933.25 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $933.25 | Professional | None | $562.34 | $851.14 | $933.25 |
Pacific Source Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $933.25 | Facility | None | $724.44 | $891.25 | $933.25 |
Pacific Source Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $933.25 | Facility | None | $467.74 | $562.34 | $933.25 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $363.08 Typical High $891.25 | Professional | None | $79.43 | $363.08 | $891.25 |
Regence BlueShield Setting Facility Modifier None Typical Low $741.31 Median $1,445.44 Typical High $3,548.13 | Facility | None | $741.31 | $1,445.44 | $3,548.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,023.29 | Professional | None | $954.99 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,513.56 | Facility | None | $1,122.02 | $1,122.02 | $1,513.56 |
United Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $676.08 | Professional | None | $323.59 | $346.74 | $676.08 |
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 $208.93 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $208.93 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $83.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $41.69 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $281.84 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Where Oregon sits
The same service costs 3.0 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· 12th of 51
$724
HI $1,072WV $363
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.