How much rates vary
Facilitymedian $158 · 10th to 90th $123 to $174Professionalmedian $98 · 10th to 90th $71 to $182
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 $87.10 Median $97.72 Typical High $100.00 | Professional | None | $87.10 | $97.72 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $338.84 Typical High $426.58 | Professional | None | $123.03 | $338.84 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $165.96 | Facility | None | $97.72 | $123.03 | $165.96 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $173.78 | Professional | None | $93.33 | $128.82 | $173.78 |
Pacific Source Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $162.18 | Facility | None | $128.82 | $158.49 | $162.18 |
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 $97.72 Median $100.00 Typical High $165.96 | Facility | None | $97.72 | $100.00 | $165.96 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $158.49 | Professional | None | $70.79 | $79.43 | $158.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $131.83 Median $257.04 Typical High $630.96 | Facility | None | $131.83 | $257.04 | $630.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | None | $165.96 | $181.97 | $181.97 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $316.23 | Facility | None | $239.88 | $239.88 | $316.23 |
United Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $141.25 | Professional | None | $66.07 | $72.44 | $141.25 |
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 $43.65 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $43.65 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $17.38 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $13.18 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.71 | $9.77 | $9.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $46.77 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $18.62 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.33 | $9.77 | $9.77 |
Where Oregon sits
The same service costs 2.8 times more in Hawaii 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· 14th of 51
$129
HI $195FL $70.79
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.