How much rates vary
Facilitymedian $513 · 10th to 90th $398 to $589Professionalmedian $324 · 10th to 90th $224 to $589
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 $295.12 Median $323.59 Typical High $323.59 | Professional | None | $295.12 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $1,122.02 Typical High $1,412.54 | Professional | None | $407.38 | $1,122.02 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $398.11 Typical High $537.03 | Facility | None | $323.59 | $398.11 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $537.03 | Professional | None | $323.59 | $489.78 | $537.03 |
Pacific Source Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $588.84 | Facility | None | $416.87 | $512.86 | $588.84 |
Pacific Source Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $524.81 | Professional | None | $416.87 | $416.87 | $524.81 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $323.59 Typical High $537.03 | Facility | None | $309.03 | $323.59 | $537.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $512.86 | Professional | None | $79.43 | $223.87 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $426.58 Median $831.76 Typical High $2,041.74 | Facility | None | $426.58 | $831.76 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | None | $549.54 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Facility | None | $794.33 | $794.33 | $1,071.52 |
United Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $478.63 | Professional | None | $223.87 | $245.47 | $478.63 |
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 $147.91 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $43.65 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $32.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $162.18 | $162.18 | $162.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $32.36 |
Where Oregon sits
The same service costs 2.7 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· 13th of 51
$417
MT $603DE $224
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.