How much rates vary
Facilitymedian $263 · 10th to 90th $200 to $302Professionalmedian $178 · 10th to 90th $120 to $324
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 $144.54 Median $177.83 Typical High $177.83 | Professional | None | $144.54 | $177.83 | $177.83 |
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 $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $562.34 Typical High $707.95 | Professional | None | $218.78 | $562.34 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $218.78 Typical High $295.12 | Facility | None | $165.96 | $218.78 | $295.12 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $295.12 | Professional | None | $177.83 | $269.15 | $295.12 |
Pacific Source Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $288.40 | Facility | None | $229.09 | $263.03 | $288.40 |
Pacific Source Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | None | $263.03 | $288.40 | $288.40 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $177.83 Typical High $295.12 | Facility | None | $165.96 | $177.83 | $295.12 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $281.84 | Professional | None | $79.43 | $125.89 | $281.84 |
Regence BlueShield Setting Facility Modifier None Typical Low $234.42 Median $457.09 Typical High $1,122.02 | Facility | None | $234.42 | $457.09 | $1,122.02 |
Regence BlueShield Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | None | $295.12 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Facility | None | $389.05 | $389.05 | $524.81 |
United Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $234.42 | Professional | None | $112.20 | $120.23 | $234.42 |
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 $72.44 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $72.44 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $28.84 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.45 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $87.10 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $35.48 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $17.78 |
Where Oregon sits
The same service costs 2.7 times more in Kansas than in Delaware. 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
$229
KS $339DE $126
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.