How much rates vary
Facilitymedian $234 · 10th to 90th $191 to $282Professionalmedian $158 · 10th to 90th $105 to $288
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 $125.89 Median $154.88 Typical High $154.88 | Professional | None | $125.89 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $478.63 Typical High $602.56 | Professional | None | $194.98 | $478.63 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $194.98 Typical High $263.03 | Facility | None | $154.88 | $194.98 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $263.03 | Professional | None | $154.88 | $239.88 | $263.03 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $234.42 Typical High $257.04 | Facility | None | $204.17 | $234.42 | $257.04 |
Pacific Source Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $173.78 Typical High $263.03 | Facility | None | $154.88 | $173.78 | $263.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $251.19 | Professional | None | $79.43 | $128.82 | $251.19 |
Regence BlueShield Setting Facility Modifier None Typical Low $208.93 Median $407.38 Typical High $1,000.00 | Facility | None | $208.93 | $407.38 | $1,000.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | None | $263.03 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $457.09 | Facility | None | $338.84 | $338.84 | $457.09 |
United Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $204.17 | Professional | None | $95.50 | $104.71 | $204.17 |
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 $63.10 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $25.12 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $18.62 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $15.49 |
Where Oregon sits
The same service costs 2.0 times more in Wisconsin 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· 12th of 51
$204
WI $257DE $129
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.