How much rates vary
Facilitymedian $151 · 10th to 90th $100 to $759Professionalmedian $148 · 10th to 90th $79 to $229
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 $79.43 Median $112.20 Typical High $112.20 | Professional | None | $79.43 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $660.69 Typical High $776.25 | Facility | None | $537.03 | $660.69 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $213.80 | Professional | None | $107.15 | $144.54 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $173.78 | Professional | None | $125.89 | $147.91 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $213.80 | Facility | None | $112.20 | $181.97 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $204.17 | Professional | None | $112.20 | $112.20 | $204.17 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $158.49 | Facility | None | $95.50 | $151.36 | $158.49 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $446.68 Typical High $11,481.54 | Facility | None | $109.65 | $446.68 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $229.09 | Professional | None | $79.43 | $147.91 | $229.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,737.80 | Facility | None | $1,148.15 | $1,548.82 | $1,737.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $234.42 | Professional | None | $147.91 | $158.49 | $234.42 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $269.15 | Professional | None | $117.49 | $165.96 | $269.15 |
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 $42.66 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $42.66 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $17.38 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.51 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $56.23 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $22.39 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $11.22 |
Where Oregon sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 11th of 51
$151
AK $316KY $70.79
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.