How much rates vary
Facilitymedian $398 · 10th to 90th $302 to $437Professionalmedian $263 · 10th to 90th $195 to $457
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 $245.47 Median $245.47 Typical High $269.15 | Professional | None | $245.47 | $245.47 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $933.25 Typical High $1,202.26 | Professional | None | $316.23 | $933.25 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $309.03 Typical High $416.87 | Facility | None | $245.47 | $309.03 | $416.87 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $426.58 | Professional | None | $245.47 | $323.59 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $416.87 | Facility | None | $323.59 | $398.11 | $416.87 |
Pacific Source Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $436.52 | Professional | None | $416.87 | $416.87 | $436.52 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $416.87 | Facility | None | $257.04 | $263.03 | $416.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $398.11 | Professional | None | $79.43 | $194.98 | $398.11 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $1,584.89 | Facility | None | $331.13 | $660.69 | $1,584.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | None | $426.58 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $891.25 | Facility | None | $676.08 | $676.08 | $891.25 |
United Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $398.11 | Professional | None | $186.21 | $204.17 | $398.11 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where Oregon sits
The same service costs 4.7 times more in Hawaii 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· 19th of 51
$324
HI $912DE $195
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.