How much rates vary
Facilitymedian $589 · 10th to 90th $457 to $661Professionalmedian $398 · 10th to 90th $263 to $676
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 $316.23 Median $371.54 Typical High $371.54 | Professional | None | $316.23 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $1,230.27 Typical High $1,548.82 | Professional | None | $467.74 | $1,230.27 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $457.09 Typical High $616.60 | Facility | None | $371.54 | $457.09 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $616.60 | Professional | None | $371.54 | $562.34 | $616.60 |
Pacific Source Setting Facility Modifier None Typical Low $478.63 Median $588.84 Typical High $602.56 | Facility | None | $478.63 | $588.84 | $602.56 |
Pacific Source Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | None | $478.63 | $478.63 | $602.56 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $398.11 Typical High $616.60 | Facility | None | $371.54 | $398.11 | $616.60 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $295.12 Typical High $588.84 | Professional | None | $79.43 | $295.12 | $588.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $489.78 Median $977.24 Typical High $2,344.23 | Facility | None | $489.78 | $977.24 | $2,344.23 |
Regence BlueShield Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | None | $630.96 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,148.15 | Facility | None | $870.96 | $870.96 | $1,148.15 |
United Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $512.86 | Professional | None | $245.47 | $263.03 | $512.86 |
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 $158.49 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $47.86 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Where Oregon sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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· 16th of 51
$479
HI $708DC $282
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.