How much rates vary
Facilitymedian $513 · 10th to 90th $389 to $550Professionalmedian $316 · 10th to 90th $191 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 $239.88 Median $316.23 Typical High $316.23 | Professional | None | $239.88 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | None | $190.55 | $190.55 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $933.25 Typical High $1,174.90 | Professional | None | $398.11 | $933.25 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $537.03 | Facility | None | $263.03 | $398.11 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $537.03 | Professional | None | $316.23 | $489.78 | $537.03 |
Pacific Source Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $537.03 | Facility | None | $416.87 | $512.86 | $537.03 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $323.59 Typical High $537.03 | Facility | None | $263.03 | $323.59 | $537.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $512.86 | Professional | None | $79.43 | $190.55 | $512.86 |
Regence BlueShield Setting Facility Modifier None Typical Low $416.87 Median $831.76 Typical High $2,041.74 | Facility | None | $416.87 | $831.76 | $2,041.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | None | $537.03 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $870.96 | Facility | None | $660.69 | $660.69 | $870.96 |
United Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $398.11 | Professional | None | $186.21 | $199.53 | $398.11 |
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 $120.23 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $36.31 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
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 $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where Oregon sits
The same service costs 3.0 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· 13th of 51
$417
HI $562DE $191
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.