How much rates vary
Facilitymedian $174 · 10th to 90th $132 to $234Professionalmedian $110 · 10th to 90th $81 to $200
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 $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $398.11 Typical High $512.86 | Professional | None | $134.90 | $398.11 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $134.90 Typical High $177.83 | Facility | None | $104.71 | $134.90 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $177.83 | Professional | None | $104.71 | $162.18 | $177.83 |
Pacific Source Setting Facility Modifier None Typical Low $141.25 Median $173.78 Typical High $229.09 | Facility | None | $141.25 | $173.78 | $229.09 |
Pacific Source Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $177.83 | Facility | None | $107.15 | $109.65 | $177.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $173.78 | Professional | None | $79.43 | $81.28 | $173.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $141.25 Median $281.84 Typical High $676.08 | Facility | None | $141.25 | $281.84 | $676.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | None | $181.97 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $380.19 | Facility | None | $288.40 | $288.40 | $380.19 |
United Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $173.78 | Professional | None | $79.43 | $87.10 | $173.78 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Where Oregon sits
The same service costs 3.0 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· 14th of 51
$141
MT $240DE $81.28
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.