How much rates vary
Facilitymedian $513 · 10th to 90th $398 to $589Professionalmedian $355 · 10th to 90th $219 to $646
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 $263.03 Median $354.81 Typical High $354.81 | Professional | None | $263.03 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $1,023.29 Typical High $1,258.93 | Professional | None | $446.68 | $1,023.29 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $588.84 | Facility | None | $331.13 | $436.52 | $588.84 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $588.84 | Professional | None | $354.81 | $537.03 | $588.84 |
Pacific Source Setting Facility Modifier None Typical Low $457.09 Median $524.81 Typical High $575.44 | Facility | None | $457.09 | $524.81 | $575.44 |
Pacific Source Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Professional | None | $524.81 | $524.81 | $645.65 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $588.84 | Facility | None | $331.13 | $363.08 | $588.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $269.15 Typical High $562.34 | Professional | None | $79.43 | $269.15 | $562.34 |
Regence BlueShield Setting Facility Modifier None Typical Low $467.74 Median $933.25 Typical High $2,238.72 | Facility | None | $467.74 | $933.25 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | None | $602.56 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Facility | None | $707.95 | $707.95 | $954.99 |
United Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $426.58 | Professional | None | $199.53 | $218.78 | $426.58 |
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 $131.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $131.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.30 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Where Oregon sits
The same service costs 2.2 times more in Wisconsin than in Pennsylvania. 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· 11th of 51
$457
WI $550PA $245
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.