How much rates vary
Facilitymedian $339 · 10th to 90th $269 to $417Professionalmedian $251 · 10th to 90th $170 to $417
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 $204.17 Median $229.09 Typical High $229.09 | Professional | None | $204.17 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $776.25 Typical High $977.24 | Professional | None | $288.40 | $776.25 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $380.19 | Facility | None | $229.09 | $281.84 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $380.19 | Professional | None | $229.09 | $346.74 | $380.19 |
Pacific Source Setting Facility Modifier None Typical Low $295.12 Median $338.84 Typical High $371.54 | Facility | None | $295.12 | $338.84 | $371.54 |
Pacific Source Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $269.15 Typical High $380.19 | Facility | None | $229.09 | $269.15 | $380.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $363.08 | Professional | None | $79.43 | $199.53 | $363.08 |
Regence BlueShield Setting Facility Modifier None Typical Low $302.00 Median $588.84 Typical High $1,445.44 | Facility | None | $302.00 | $588.84 | $1,445.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | None | $389.05 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $741.31 | Facility | None | $549.54 | $549.54 | $741.31 |
United Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $331.13 | Professional | None | $154.88 | $169.82 | $331.13 |
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 $102.33 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $40.74 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where Oregon sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 16th of 51
$295
WI $407CO $200
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.