How much rates vary
Facilitymedian $191 · 10th to 90th $112 to $589Professionalmedian $158 · 10th to 90th $74 to $282
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 $89.13 Median $89.13 Typical High $95.50 | Professional | None | $89.13 | $89.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $158.49 Typical High $269.15 | Facility | None | $138.04 | $158.49 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $169.82 | Professional | None | $53.70 | $81.28 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $275.42 | Professional | None | $93.33 | $158.49 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $138.04 Typical High $239.88 | Facility | None | $89.13 | $138.04 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $234.42 | Professional | None | $89.13 | $95.50 | $234.42 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $190.55 | Facility | None | $112.20 | $181.97 | $190.55 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $223.87 Typical High $380.19 | Facility | None | $93.33 | $223.87 | $380.19 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $169.82 Typical High $275.42 | Professional | None | $74.13 | $169.82 | $275.42 |
Regence BlueShield Setting Facility Modifier None Typical Low $457.09 Median $602.56 Typical High $676.08 | Facility | None | $457.09 | $602.56 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $281.84 | Professional | None | $158.49 | $177.83 | $281.84 |
United Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $831.76 | Facility | None | $537.03 | $676.08 | $831.76 |
United Setting Professional Modifier None Typical Low $56.23 Median $151.36 Typical High $331.13 | Professional | None | $56.23 | $151.36 | $331.13 |
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 $44.67 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $44.67 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $19.05 | Professional | 53 · Discontinued | $17.78 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $14.45 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $42.66 | $44.67 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.78 Typical High $19.05 | Professional | 53 · Discontinued | $17.38 | $17.78 | $19.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $14.45 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.71 | $8.91 | $9.55 |
Where Oregon sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 3rd of 51
$170
AK $269AL $53.70
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.