How much rates vary
Facilitymedian $195 · 10th to 90th $145 to $219Professionalmedian $117 · 10th to 90th $89 to $219
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 $112.20 Median $117.49 Typical High $123.03 | Professional | None | $112.20 | $117.49 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $416.87 Typical High $524.81 | Professional | None | $147.91 | $416.87 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $169.82 Typical High $199.53 | Facility | None | $117.49 | $169.82 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $208.93 | Professional | None | $117.49 | $181.97 | $208.93 |
Pacific Source Setting Facility Modifier None Typical Low $190.55 Median $194.98 Typical High $199.53 | Facility | None | $190.55 | $194.98 | $199.53 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $199.53 | Facility | None | $120.23 | $125.89 | $199.53 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $190.55 | Professional | None | $79.43 | $93.33 | $190.55 |
Providence Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Regence BlueShield Setting Facility Modifier None Typical Low $154.88 Median $309.03 Typical High $758.58 | Facility | None | $154.88 | $309.03 | $758.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | None | $199.53 | $218.78 | $218.78 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $389.05 | Facility | None | $295.12 | $295.12 | $389.05 |
United Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $177.83 | Professional | None | $85.11 | $89.13 | $177.83 |
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 $56.23 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $56.23 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $22.39 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $57.54 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $23.44 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $11.75 |
Where Oregon sits
The same service costs 2.1 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· 15th of 51
$158
HI $200DE $93.33
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.