How much rates vary
Facilitymedian $234 · 10th to 90th $182 to $263Professionalmedian $158 · 10th to 90th $112 to $269
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 $134.90 Median $144.54 Typical High $144.54 | Professional | None | $134.90 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $512.86 Typical High $645.65 | Professional | None | $181.97 | $512.86 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $181.97 Typical High $245.47 | Facility | None | $144.54 | $181.97 | $245.47 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $245.47 | Professional | None | $144.54 | $223.87 | $245.47 |
Pacific Source Setting Facility Modifier None Typical Low $190.55 Median $234.42 Typical High $263.03 | Facility | None | $190.55 | $234.42 | $263.03 |
Pacific Source Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | None | $239.88 | $239.88 | $263.03 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $158.49 Typical High $245.47 | Facility | None | $147.91 | $158.49 | $245.47 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $234.42 | Professional | None | $79.43 | $117.49 | $234.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $194.98 Median $380.19 Typical High $933.25 | Facility | None | $194.98 | $380.19 | $933.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | None | $245.47 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Facility | None | $363.08 | $363.08 | $489.78 |
United Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $218.78 | Professional | None | $102.33 | $112.20 | $218.78 |
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 $67.61 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $26.92 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.49 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $29.51 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Where Oregon sits
The same service costs 2.4 times more in Hawaii than in New Jersey. 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
$191
HI $282NJ $117
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.