How much rates vary
Facilitymedian $741 · 10th to 90th $617 to $933Professionalmedian $513 · 10th to 90th $316 to $955
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 $380.19 Median $512.86 Typical High $512.86 | Professional | None | $380.19 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,479.11 Typical High $1,862.09 | Professional | None | $645.65 | $1,479.11 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $645.65 Typical High $870.96 | Facility | None | $457.09 | $645.65 | $870.96 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $870.96 | Professional | None | $512.86 | $794.33 | $870.96 |
Pacific Source Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $851.14 | Facility | None | $616.60 | $741.31 | $851.14 |
Pacific Source Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $933.25 | Professional | None | $676.08 | $676.08 | $933.25 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $524.81 Typical High $870.96 | Facility | None | $457.09 | $524.81 | $870.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $389.05 Typical High $831.76 | Professional | None | $79.43 | $389.05 | $831.76 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $3,311.31 | Facility | None | $676.08 | $1,348.96 | $3,311.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | None | $870.96 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,380.38 | Facility | None | $1,047.13 | $1,047.13 | $1,380.38 |
United Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $616.60 | Professional | None | $295.12 | $316.23 | $616.60 |
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 $190.55 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $190.55 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $75.86 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $57.54 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.02 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Where Oregon sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 11th of 51
$631
HI $851PA $363
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.