How much rates vary
Facilitymedian $240 · 10th to 90th $162 to $525Professionalmedian $162 · 10th to 90th $151 to $224
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 $194.98 Median $194.98 Typical High $239.88 | Facility | None | $194.98 | $194.98 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $223.87 | Professional | None | $162.18 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $346.74 | Facility | None | $169.82 | $309.03 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | None | $162.18 | $162.18 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $380.19 Typical High $478.63 | Professional | None | $186.21 | $380.19 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $177.83 Typical High $489.78 | Facility | None | $162.18 | $177.83 | $489.78 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $251.19 | Professional | None | $162.18 | $177.83 | $251.19 |
Pacific Source Setting Facility Modifier None Typical Low $177.83 Median $234.42 Typical High $363.08 | Facility | None | $177.83 | $234.42 | $363.08 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $218.78 Typical High $537.03 | Facility | None | $186.21 | $218.78 | $537.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $223.87 | Professional | None | $79.43 | $173.78 | $223.87 |
Regence BlueShield Setting Facility Modifier None Typical Low $218.78 Median $302.00 Typical High $537.03 | Facility | None | $218.78 | $302.00 | $537.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | None | $151.36 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $162.18 Median $331.13 Typical High $389.05 | Facility | None | $162.18 | $331.13 | $389.05 |
United Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | None | $177.83 | $177.83 | $204.17 |
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 $79.43 Median $79.43 Typical High $81.28 | Professional | 52 · Reduced service | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $16.22 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $16.22 |
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 |
Moda Health Setting Professional Modifier JZ · No drug discarded Typical Low $181.97 Median $251.19 Typical High $575.44 | Professional | JZ · No drug discarded | $181.97 | $251.19 | $575.44 |
Where Oregon sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 46th of 51
$162
WY $302NV $162
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.