How much rates vary
Facilitymedian $186 · 10th to 90th $115 to $257Professionalmedian $138 · 10th to 90th $87 to $245
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 Facility Modifier None Typical Low $120.23 Median $158.49 Typical High $257.04 | Facility | None | $120.23 | $158.49 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $158.49 | Professional | None | $79.43 | $120.23 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $245.47 | Professional | None | $89.13 | $144.54 | $245.47 |
HealthNet Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $316.23 | Professional | None | $245.47 | $281.84 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $281.84 | Professional | None | $83.18 | $165.96 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $263.03 | Facility | None | $100.00 | $158.49 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $275.42 | Professional | None | $87.10 | $138.04 | $275.42 |
Pacific Source Setting Facility Modifier None Typical Low $123.03 Median $204.17 Typical High $223.87 | Facility | None | $123.03 | $204.17 | $223.87 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $181.97 Typical High $257.04 | Facility | None | $81.28 | $181.97 | $257.04 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $158.49 Typical High $251.19 | Professional | None | $79.43 | $158.49 | $251.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $194.98 | Professional | None | $134.90 | $181.97 | $194.98 |
United Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $263.03 | Professional | None | $112.20 | $173.78 | $263.03 |
9 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 $45.71 Median $50.12 Typical High $67.61 | Professional | 52 · Reduced service | $45.71 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $20.42 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $13.80 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $87.10 Median $173.78 Typical High $309.03 | Professional | 25 · Same-day visit | $87.10 | $173.78 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | 52 · Reduced service | $50.12 | $50.12 | $67.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $20.42 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $13.80 |
Moda Health Setting Professional Modifier 57 · Decision for surgery Typical Low $91.20 Median $131.83 Typical High $331.13 | Professional | 57 · Decision for surgery | $91.20 | $131.83 | $331.13 |
Moda Health Setting Professional Modifier GC · Resident with teaching physician Typical Low $81.28 Median $123.03 Typical High $363.08 | Professional | GC · Resident with teaching physician | $81.28 | $123.03 | $363.08 |
Where Oregon sits
The same service costs 2.3 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· 7th of 51
$138
AK $170AL $74.13
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.