How much rates vary
Facilitymedian $490 · 10th to 90th $380 to $550Professionalmedian $302 · 10th to 90th $178 to $562
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 $234.42 Median $302.00 Typical High $302.00 | Professional | None | $234.42 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $912.01 Typical High $1,148.15 | Professional | None | $389.05 | $912.01 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $512.86 | Facility | None | $295.12 | $380.19 | $512.86 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $512.86 | Professional | None | $302.00 | $467.74 | $512.86 |
Pacific Source Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $501.19 | Facility | None | $398.11 | $489.78 | $501.19 |
Pacific Source Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $549.54 | Professional | None | $489.78 | $501.19 | $549.54 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $512.86 | Facility | None | $245.47 | $316.23 | $512.86 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $489.78 | Professional | None | $79.43 | $177.83 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $407.38 Median $794.33 Typical High $1,949.84 | Facility | None | $407.38 | $794.33 | $1,949.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | None | $524.81 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $851.14 | Facility | None | $645.65 | $645.65 | $851.14 |
United Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $389.05 | Professional | None | $177.83 | $194.98 | $389.05 |
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 $117.49 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $117.49 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $46.77 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $117.49 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $46.77 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $30.20 |
Where Oregon sits
The same service costs 2.9 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· 12th of 51
$398
MT $513DE $178
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.