How much rates vary
Facilitymedian $282 · 10th to 90th $214 to $316Professionalmedian $178 · 10th to 90th $129 to $324
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 $165.96 Median $173.78 Typical High $173.78 | Professional | None | $165.96 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $630.96 Typical High $812.83 | Professional | None | $218.78 | $630.96 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $213.80 Typical High $288.40 | Facility | None | $173.78 | $213.80 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $288.40 | Professional | None | $173.78 | $263.03 | $288.40 |
Pacific Source Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $295.12 | Facility | None | $229.09 | $281.84 | $295.12 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $288.40 | Facility | None | $173.78 | $177.83 | $288.40 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $281.84 | Professional | None | $79.43 | $128.82 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $229.09 Median $457.09 Typical High $1,096.48 | Facility | None | $229.09 | $457.09 | $1,096.48 |
Regence BlueShield Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | None | $295.12 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $602.56 | Facility | None | $457.09 | $457.09 | $602.56 |
United Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $269.15 | Professional | None | $128.82 | $138.04 | $269.15 |
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 $83.18 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $33.11 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $16.60 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $87.10 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Where Oregon sits
The same service costs 3.5 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· 15th of 51
$229
HI $447DE $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.