How much rates vary
Facilitymedian $219 · 10th to 90th $170 to $240Professionalmedian $155 · 10th to 90th $102 to $251
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 $123.03 Median $134.90 Typical High $134.90 | Professional | None | $123.03 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $478.63 Typical High $588.84 | Professional | None | $169.82 | $478.63 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $229.09 | Facility | None | $134.90 | $169.82 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $229.09 | Professional | None | $134.90 | $208.93 | $229.09 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $223.87 | Facility | None | $177.83 | $218.78 | $223.87 |
Pacific Source Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $229.09 | Facility | None | $134.90 | $169.82 | $229.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $218.78 | Professional | None | $79.43 | $123.03 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $177.83 Median $354.81 Typical High $870.96 | Facility | None | $177.83 | $354.81 | $870.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | None | $229.09 | $251.19 | $251.19 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Facility | None | $331.13 | $331.13 | $446.68 |
United Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $199.53 | Professional | None | $93.33 | $102.33 | $199.53 |
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 $61.66 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $24.55 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $18.20 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
Where Oregon sits
The same service costs 2.7 times more in Hawaii than in Washington, DC. 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
$178
HI $295DC $110
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.