How much rates vary
Facilitymedian $209 · 10th to 90th $158 to $234Professionalmedian $135 · 10th to 90th $93 to $240
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 $112.20 Median $125.89 Typical High $125.89 | Professional | None | $112.20 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | None | $107.15 | $107.15 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $436.52 Typical High $549.54 | Professional | None | $162.18 | $436.52 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $213.80 | Facility | None | $125.89 | $158.49 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $213.80 | Professional | None | $125.89 | $194.98 | $213.80 |
Pacific Source Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $213.80 | Facility | None | $169.82 | $208.93 | $213.80 |
Pacific Source Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $147.91 Typical High $213.80 | Facility | None | $125.89 | $147.91 | $213.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $208.93 | Professional | None | $79.43 | $107.15 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $169.82 Median $338.84 Typical High $812.83 | Facility | None | $169.82 | $338.84 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $239.88 | Professional | None | $218.78 | $239.88 | $239.88 |
United Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $407.38 | Facility | None | $309.03 | $309.03 | $407.38 |
United Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $181.97 | Professional | None | $85.11 | $93.33 | $181.97 |
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 $56.23 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $22.39 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $16.98 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $60.26 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $23.99 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $12.59 |
Where Oregon sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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· 15th of 51
$170
KS $575WV $107
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.