How much rates vary
Facilitymedian $224 · 10th to 90th $182 to $245Professionalmedian $166 · 10th to 90th $110 to $257
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 $141.25 Typical High $141.25 | Professional | None | $134.90 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $181.97 | Professional | None | $131.83 | $131.83 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $501.19 Typical High $645.65 | Professional | None | $177.83 | $501.19 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $173.78 Typical High $234.42 | Facility | None | $141.25 | $173.78 | $234.42 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $234.42 | Professional | None | $141.25 | $213.80 | $234.42 |
Pacific Source Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $229.09 | Facility | None | $181.97 | $223.87 | $229.09 |
Pacific Source Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $181.97 Typical High $234.42 | Facility | None | $141.25 | $181.97 | $234.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $223.87 | Professional | None | $79.43 | $131.83 | $223.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $891.25 | Facility | None | $186.21 | $363.08 | $891.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | None | $239.88 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $478.63 | Facility | None | $363.08 | $363.08 | $478.63 |
United Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $218.78 | Professional | None | $102.33 | $109.65 | $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 $66.07 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $66.07 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $26.92 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $19.95 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.49 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Where Oregon sits
The same service costs 3.5 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· 15th of 51
$182
HI $427DC $120
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.