How much rates vary
Facilitymedian $646 · 10th to 90th $501 to $813Professionalmedian $447 · 10th to 90th $302 to $832
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 $380.19 Median $446.68 Typical High $446.68 | Professional | None | $380.19 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $416.87 | Professional | None | $302.00 | $302.00 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $1,479.11 Typical High $1,862.09 | Professional | None | $562.34 | $1,479.11 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $380.19 Median $562.34 Typical High $758.58 | Facility | None | $380.19 | $562.34 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $758.58 | Professional | None | $446.68 | $691.83 | $758.58 |
Pacific Source Setting Facility Modifier None Typical Low $588.84 Median $660.69 Typical High $741.31 | Facility | None | $588.84 | $660.69 | $741.31 |
Pacific Source Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | None | $660.69 | $741.31 | $741.31 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $457.09 Typical High $758.58 | Facility | None | $416.87 | $457.09 | $758.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $302.00 Typical High $724.44 | Professional | None | $79.43 | $302.00 | $724.44 |
Regence BlueShield Setting Facility Modifier None Typical Low $588.84 Median $1,174.90 Typical High $2,884.03 | Facility | None | $588.84 | $1,174.90 | $2,884.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | None | $758.58 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,380.38 | Facility | None | $1,047.13 | $1,047.13 | $1,380.38 |
United Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $616.60 | Professional | None | $295.12 | $316.23 | $616.60 |
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 $190.55 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $190.55 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Where Oregon sits
The same service costs 3.9 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· 15th of 51
$589
HI $1,175DE $302
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.