How much rates vary
Facilitymedian $138 · 10th to 90th $110 to $162Professionalmedian $89 · 10th to 90th $63 to $166
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 $83.18 Median $89.13 Typical High $91.20 | Professional | None | $83.18 | $89.13 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $316.23 Typical High $398.11 | Professional | None | $114.82 | $316.23 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $151.36 | Facility | None | $89.13 | $112.20 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $151.36 | Professional | None | $89.13 | $134.90 | $151.36 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $144.54 Typical High $147.91 | Facility | None | $117.49 | $144.54 | $147.91 |
Pacific Source Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $93.33 Typical High $151.36 | Facility | None | $87.10 | $93.33 | $151.36 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $144.54 | Professional | None | $63.10 | $79.43 | $144.54 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $234.42 Typical High $575.44 | Facility | None | $120.23 | $234.42 | $575.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | None | $154.88 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $302.00 | Facility | None | $223.87 | $223.87 | $302.00 |
United Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $134.90 | Professional | None | $63.10 | $69.18 | $134.90 |
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 $41.69 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $41.69 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $16.60 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $12.30 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where Oregon sits
The same service costs 2.5 times more in Arkansas than in Florida. 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· 13th of 51
$117
AR $158FL $64.57
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.