How much rates vary
Facilitymedian $224 · 10th to 90th $170 to $275Professionalmedian $162 · 10th to 90th $105 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 $125.89 Median $138.04 Typical High $138.04 | Professional | None | $125.89 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $489.78 Typical High $616.60 | Professional | None | $173.78 | $489.78 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $229.09 | Facility | None | $138.04 | $169.82 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $229.09 | Professional | None | $138.04 | $208.93 | $229.09 |
Pacific Source Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $251.19 | Facility | None | $181.97 | $223.87 | $251.19 |
Pacific Source Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $269.15 | Professional | None | $181.97 | $229.09 | $269.15 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $229.09 | Facility | None | $138.04 | $165.96 | $229.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $223.87 | Professional | None | $79.43 | $120.23 | $223.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $181.97 Median $363.08 Typical High $870.96 | Facility | None | $181.97 | $363.08 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | None | $234.42 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $457.09 | Facility | None | $346.74 | $346.74 | $457.09 |
United Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $204.17 | Professional | None | $97.72 | $104.71 | $204.17 |
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 $63.10 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $25.12 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.59 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
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 $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where Oregon sits
The same service costs 2.8 times more in Hawaii than in Delaware. 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
$182
HI $331DE $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.