How much rates vary
Facilitymedian $692 · 10th to 90th $525 to $759Professionalmedian $490 · 10th to 90th $324 to $794
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 $389.05 Median $426.58 Typical High $426.58 | Professional | None | $389.05 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $1,513.56 Typical High $1,905.46 | Professional | None | $537.03 | $1,513.56 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $524.81 Typical High $707.95 | Facility | None | $426.58 | $524.81 | $707.95 |
Moda Health Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $707.95 | Professional | None | $426.58 | $645.65 | $707.95 |
Pacific Source Setting Facility Modifier None Typical Low $562.34 Median $691.83 Typical High $707.95 | Facility | None | $562.34 | $691.83 | $707.95 |
Pacific Source Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $489.78 Typical High $707.95 | Facility | None | $426.58 | $489.78 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $691.83 | Professional | None | $79.43 | $354.81 | $691.83 |
Regence BlueShield Setting Facility Modifier None Typical Low $562.34 Median $1,122.02 Typical High $2,691.53 | Facility | None | $562.34 | $1,122.02 | $2,691.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | None | $724.44 | $794.33 | $794.33 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,412.54 | Facility | None | $1,071.52 | $1,071.52 | $1,412.54 |
United Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $645.65 | Professional | None | $302.00 | $323.59 | $645.65 |
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 $194.98 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $79.43 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $213.80 | $213.80 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $42.66 |
Where Oregon sits
The same service costs 2.4 times more in Iowa than in Kansas. 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· 12th of 51
$562
IA $776KS $324
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.