How much rates vary
Facilitymedian $251 · 10th to 90th $178 to $282Professionalmedian $162 · 10th to 90th $117 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 $154.88 Median $158.49 Typical High $158.49 | Professional | None | $154.88 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $162.18 | Professional | None | $117.49 | $117.49 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $588.84 Typical High $758.58 | Professional | None | $199.53 | $588.84 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $194.98 Typical High $263.03 | Facility | None | $158.49 | $194.98 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $263.03 | Professional | None | $158.49 | $239.88 | $263.03 |
Pacific Source Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $257.04 | Facility | None | $204.17 | $251.19 | $257.04 |
Pacific Source Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $165.96 Typical High $263.03 | Facility | None | $158.49 | $165.96 | $263.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $251.19 | Professional | None | $79.43 | $117.49 | $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 $269.15 Median $288.40 Typical High $288.40 | Professional | None | $269.15 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $562.34 | Facility | None | $426.58 | $426.58 | $562.34 |
United Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $251.19 | Professional | None | $120.23 | $128.82 | $251.19 |
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 $77.62 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $77.62 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $30.90 | $31.62 | $31.62 |
Aetna 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 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Oregon sits
The same service costs 2.8 times more in Minnesota 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· 16th of 51
$204
MN $331DE $117
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.