How much rates vary
Facilitymedian $417 · 10th to 90th $331 to $525Professionalmedian $288 · 10th to 90th $200 to $537
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 $251.19 Median $288.40 Typical High $288.40 | Professional | None | $251.19 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $954.99 Typical High $1,202.26 | Professional | None | $363.08 | $954.99 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $489.78 | Facility | None | $257.04 | $363.08 | $489.78 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $489.78 | Professional | None | $288.40 | $446.68 | $489.78 |
Pacific Source Setting Facility Modifier None Typical Low $380.19 Median $426.58 Typical High $478.63 | Facility | None | $380.19 | $426.58 | $478.63 |
Pacific Source Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $478.63 | Professional | None | $416.87 | $416.87 | $478.63 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $288.40 Typical High $489.78 | Facility | None | $269.15 | $288.40 | $489.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $467.74 | Professional | None | $79.43 | $199.53 | $467.74 |
Regence BlueShield Setting Facility Modifier None Typical Low $380.19 Median $758.58 Typical High $1,862.09 | Facility | None | $380.19 | $758.58 | $1,862.09 |
Regence BlueShield Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | None | $489.78 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $891.25 | Facility | None | $676.08 | $676.08 | $891.25 |
United Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $407.38 | Professional | None | $190.55 | $208.93 | $407.38 |
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 $123.03 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $50.12 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.12 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $28.84 |
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· 13th of 51
$380
HI $617FL $214
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.