How much rates vary
Facilitymedian $447 · 10th to 90th $339 to $513Professionalmedian $309 · 10th to 90th $204 to $575
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 $245.47 Median $309.03 Typical High $309.03 | Professional | None | $245.47 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $954.99 Typical High $1,202.26 | Professional | None | $389.05 | $954.99 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $380.19 Typical High $512.86 | Facility | None | $275.42 | $380.19 | $512.86 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $512.86 | Professional | None | $309.03 | $467.74 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $407.38 Median $457.09 Typical High $512.86 | Facility | None | $407.38 | $457.09 | $512.86 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $309.03 Typical High $512.86 | Facility | None | $275.42 | $309.03 | $512.86 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $501.19 | Professional | None | $79.43 | $218.78 | $501.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $1,949.84 | Facility | None | $407.38 | $812.83 | $1,949.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | None | $524.81 | $575.44 | $575.44 |
United Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $891.25 | Facility | None | $660.69 | $660.69 | $891.25 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $398.11 | Professional | None | $186.21 | $204.17 | $398.11 |
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 $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $123.03 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $48.98 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $37.15 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $24.55 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $30.90 |
Where Oregon sits
The same service costs 2.5 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· 12th of 51
$407
HI $550PA $219
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.