How much rates vary
Facilitymedian $148 · 10th to 90th $110 to $200Professionalmedian $98 · 10th to 90th $71 to $170
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 $91.20 Median $91.20 Typical High $100.00 | Professional | None | $91.20 | $91.20 | $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 $114.82 Median $338.84 Typical High $436.52 | Professional | None | $114.82 | $338.84 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $154.88 | Facility | None | $91.20 | $114.82 | $154.88 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $154.88 | Professional | None | $91.20 | $138.04 | $154.88 |
Pacific Source Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $194.98 | Facility | None | $120.23 | $147.91 | $194.98 |
Pacific Source Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | None | $134.90 | $134.90 | $151.36 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $154.88 | Facility | None | $93.33 | $97.72 | $154.88 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $147.91 | Professional | None | $70.79 | $79.43 | $147.91 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $588.84 | Facility | None | $120.23 | $239.88 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | None | $154.88 | $169.82 | $169.82 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $331.13 | Facility | None | $245.47 | $245.47 | $331.13 |
United Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $147.91 | Professional | None | $67.61 | $75.86 | $147.91 |
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 $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where Oregon sits
The same service costs 3.2 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· 17th of 51
$120
HI $224FL $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.