How much rates vary
Facilitymedian $158 · 10th to 90th $110 to $204Professionalmedian $151 · 10th to 90th $79 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 $128.82 Typical High $199.53 | Facility | None | $120.23 | $128.82 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $199.53 | Professional | None | $81.28 | $147.91 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $251.19 | Professional | None | $117.49 | $151.36 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $199.53 | Professional | None | $128.82 | $169.82 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $204.17 Typical High $398.11 | Facility | None | $151.36 | $204.17 | $398.11 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $151.36 Typical High $257.04 | Professional | None | $77.62 | $151.36 | $257.04 |
Pacific Source Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $194.98 | Facility | None | $107.15 | $158.49 | $194.98 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $204.17 Typical High $263.03 | Facility | None | $85.11 | $204.17 | $263.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $251.19 | Professional | None | $79.43 | $173.78 | $251.19 |
Regence BlueShield Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $245.47 | Professional | None | $138.04 | $144.54 | $245.47 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $281.84 | Professional | None | $125.89 | $190.55 | $281.84 |
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 $38.90 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $38.90 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $11.48 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $83.18 Median $239.88 Typical High $380.19 | Professional | 25 · Same-day visit | $83.18 | $239.88 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $38.90 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $11.48 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 57 · Decision for surgery Typical Low $83.18 Median $229.09 Typical High $323.59 | Professional | 57 · Decision for surgery | $83.18 | $229.09 | $323.59 |
Moda Health Setting Professional Modifier AI · Physician of record Typical Low $85.11 Median $208.93 Typical High $295.12 | Professional | AI · Physician of record | $85.11 | $208.93 | $295.12 |
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· 3rd of 51
$155
AK $174AL $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.