How much rates vary
Facilitymedian $195 · 10th to 90th $155 to $214Professionalmedian $126 · 10th to 90th $93 to $229
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 $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $436.52 Typical High $562.34 | Professional | None | $158.49 | $436.52 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $208.93 | Facility | None | $125.89 | $154.88 | $208.93 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $208.93 | Professional | None | $125.89 | $190.55 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $162.18 Median $194.98 Typical High $204.17 | Facility | None | $162.18 | $194.98 | $204.17 |
Pacific Source Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $208.93 | Facility | None | $125.89 | $125.89 | $208.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $199.53 | Professional | None | $79.43 | $93.33 | $199.53 |
Regence BlueShield Setting Facility Modifier None Typical Low $165.96 Median $331.13 Typical High $794.33 | Facility | None | $165.96 | $331.13 | $794.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | None | $213.80 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $416.87 | Facility | None | $316.23 | $316.23 | $416.87 |
United Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $186.21 | Professional | None | $89.13 | $95.50 | $186.21 |
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 $57.54 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $57.54 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $22.91 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Where Oregon sits
The same service costs 2.9 times more in Hawaii than in Florida. 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
$162
HI $269FL $93.33
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.