How much rates vary
Facilitymedian $813 · 10th to 90th $631 to $912Professionalmedian $501 · 10th to 90th $398 to $933
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 $478.63 Median $501.19 Typical High $524.81 | Professional | None | $478.63 | $501.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $1,819.70 Typical High $2,344.23 | Professional | None | $630.96 | $1,819.70 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $851.14 | Facility | None | $501.19 | $630.96 | $851.14 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $851.14 | Professional | None | $501.19 | $645.65 | $851.14 |
Pacific Source Setting Facility Modifier None Typical Low $660.69 Median $812.83 Typical High $851.14 | Facility | None | $660.69 | $812.83 | $851.14 |
Pacific Source Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | None | $831.76 | $831.76 | $851.14 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $549.54 Typical High $851.14 | Facility | None | $512.86 | $549.54 | $851.14 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $812.83 | Professional | None | $79.43 | $398.11 | $812.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $676.08 Median $1,318.26 Typical High $3,235.94 | Facility | None | $676.08 | $1,318.26 | $3,235.94 |
Regence BlueShield Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,737.80 | Facility | None | $1,318.26 | $1,318.26 | $1,737.80 |
United Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $776.25 | Professional | None | $363.08 | $398.11 | $776.25 |
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 $239.88 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $239.88 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $239.88 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $95.50 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $47.86 | $50.12 | $50.12 |
Where Oregon sits
The same service costs 2.4 times more in Iowa 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· 18th of 51
$661
IA $955DE $398
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.