How much rates vary
Facilitymedian $186 · 10th to 90th $141 to $200Professionalmedian $115 · 10th to 90th $87 to $214
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 $109.65 Median $114.82 Typical High $114.82 | Professional | None | $109.65 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | None | $95.50 | $95.50 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $407.38 Typical High $501.19 | Professional | None | $154.88 | $407.38 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $194.98 | Facility | None | $114.82 | $162.18 | $194.98 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $194.98 | Professional | None | $114.82 | $173.78 | $194.98 |
Pacific Source Setting Facility Modifier None Typical Low $151.36 Median $186.21 Typical High $194.98 | Facility | None | $151.36 | $186.21 | $194.98 |
Pacific Source Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $128.82 Typical High $194.98 | Facility | None | $117.49 | $128.82 | $194.98 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $186.21 | Professional | None | $79.43 | $95.50 | $186.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $151.36 Median $302.00 Typical High $741.31 | Facility | None | $151.36 | $302.00 | $741.31 |
Regence BlueShield Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | None | $194.98 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $380.19 | Facility | None | $281.84 | $281.84 | $380.19 |
United Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $169.82 | Professional | None | $79.43 | $87.10 | $169.82 |
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 $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $20.89 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $15.49 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $56.23 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.39 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.22 | $11.48 | $11.48 |
Where Oregon sits
The same service costs 2.5 times more in Kansas than in Utah. 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
$151
KS $234UT $95.50
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.