How much rates vary
Facilitymedian $229 · 10th to 90th $174 to $257Professionalmedian $141 · 10th to 90th $107 to $263
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 $128.82 Median $141.25 Typical High $141.25 | Professional | None | $128.82 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $489.78 Typical High $616.60 | Professional | None | $190.55 | $489.78 | $616.60 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $199.53 Typical High $239.88 | Facility | None | $141.25 | $199.53 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $239.88 | Professional | None | $138.04 | $177.83 | $239.88 |
Pacific Source Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $239.88 | Facility | None | $186.21 | $229.09 | $239.88 |
Pacific Source Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | None | $234.42 | $234.42 | $239.88 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $239.88 | Facility | None | $144.54 | $151.36 | $239.88 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $229.09 | Professional | None | $79.43 | $112.20 | $229.09 |
Regence BlueShield Setting Facility Modifier None Typical Low $186.21 Median $371.54 Typical High $912.01 | Facility | None | $186.21 | $371.54 | $912.01 |
Regence BlueShield Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | None | $239.88 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $467.74 | Facility | None | $346.74 | $346.74 | $467.74 |
United Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $208.93 | Professional | None | $97.72 | $107.15 | $208.93 |
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 $64.57 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $25.70 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.88 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $27.54 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.80 | $14.13 | $14.13 |
Where Oregon sits
The same service costs 2.1 times more in Hawaii 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· 13th of 51
$186
HI $240UT $112
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.