How much rates vary
Facilitymedian $501 · 10th to 90th $407 to $603Professionalmedian $363 · 10th to 90th $240 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 $288.40 Median $338.84 Typical High $338.84 | Professional | None | $288.40 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $1,122.02 Typical High $1,412.54 | Professional | None | $426.58 | $1,122.02 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $416.87 Typical High $562.34 | Facility | None | $338.84 | $416.87 | $562.34 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $562.34 | Professional | None | $338.84 | $512.86 | $562.34 |
Pacific Source Setting Facility Modifier None Typical Low $436.52 Median $537.03 Typical High $549.54 | Facility | None | $436.52 | $537.03 | $549.54 |
Pacific Source Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | None | $478.63 | $549.54 | $549.54 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $363.08 Typical High $562.34 | Facility | None | $338.84 | $363.08 | $562.34 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $269.15 Typical High $537.03 | Professional | None | $79.43 | $269.15 | $537.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $446.68 Median $870.96 Typical High $2,137.96 | Facility | None | $446.68 | $870.96 | $2,137.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | None | $575.44 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $1,047.13 | Facility | None | $794.33 | $794.33 | $1,047.13 |
United Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $467.74 | Professional | None | $223.87 | $239.88 | $467.74 |
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 $144.54 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii than in Vermont. 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· 14th of 51
$437
HI $708VT $269
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.