How much rates vary
Facilitymedian $646 · 10th to 90th $501 to $741Professionalmedian $398 · 10th to 90th $302 to $741
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 $380.19 Median $398.11 Typical High $398.11 | Professional | None | $380.19 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $1,412.54 Typical High $1,778.28 | Professional | None | $501.19 | $1,412.54 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $676.08 | Facility | None | $398.11 | $562.34 | $676.08 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $676.08 | Professional | None | $398.11 | $575.44 | $676.08 |
Pacific Source Setting Facility Modifier None Typical Low $524.81 Median $645.65 Typical High $691.83 | Facility | None | $524.81 | $645.65 | $691.83 |
Pacific Source Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $724.44 | Professional | None | $588.84 | $660.69 | $724.44 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $416.87 Typical High $676.08 | Facility | None | $407.38 | $416.87 | $676.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $309.03 Typical High $645.65 | Professional | None | $79.43 | $309.03 | $645.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $537.03 Median $1,047.13 Typical High $2,570.40 | Facility | None | $537.03 | $1,047.13 | $2,570.40 |
Regence BlueShield Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | None | $676.08 | $741.31 | $741.31 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Facility | None | $977.24 | $977.24 | $1,318.26 |
United Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $588.84 | Professional | None | $275.42 | $302.00 | $588.84 |
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 $181.97 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $181.97 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $72.44 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $77.62 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $39.81 |
Where Oregon sits
The same service costs 2.2 times more in Montana than in Delaware. 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· 16th of 51
$525
MT $692DE $309
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.