How much rates vary
Facilitymedian $224 · 10th to 90th $195 to $269Professionalmedian $170 · 10th to 90th $112 to $275
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 $134.90 Median $147.91 Typical High $147.91 | Professional | None | $134.90 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | None | $141.25 | $141.25 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $524.81 Typical High $660.69 | Professional | None | $186.21 | $524.81 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $251.19 | Facility | None | $147.91 | $186.21 | $251.19 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $251.19 | Professional | None | $147.91 | $223.87 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $194.98 Median $223.87 Typical High $245.47 | Facility | None | $194.98 | $223.87 | $245.47 |
Pacific Source Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $251.19 | Facility | None | $147.91 | $194.98 | $251.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $239.88 | Professional | None | $79.43 | $141.25 | $239.88 |
Regence BlueShield Setting Facility Modifier None Typical Low $194.98 Median $389.05 Typical High $954.99 | Facility | None | $194.98 | $389.05 | $954.99 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | None | $251.19 | $275.42 | $275.42 |
United Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $489.78 | Facility | None | $371.54 | $371.54 | $489.78 |
United Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $218.78 | Professional | None | $104.71 | $112.20 | $218.78 |
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 $67.61 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $67.61 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $26.92 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $20.42 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $13.49 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $29.51 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $14.79 |
Where Oregon sits
The same service costs 3.2 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· 14th of 51
$195
HI $407DC $129
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.