How much rates vary
Facilitymedian $363 · 10th to 90th $302 to $457Professionalmedian $251 · 10th to 90th $166 to $468
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 $204.17 Median $251.19 Typical High $251.19 | Professional | None | $204.17 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $776.25 Typical High $977.24 | Professional | None | $316.23 | $776.25 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $426.58 | Facility | None | $245.47 | $316.23 | $426.58 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $426.58 | Professional | None | $251.19 | $380.19 | $426.58 |
Pacific Source Setting Facility Modifier None Typical Low $331.13 Median $371.54 Typical High $416.87 | Facility | None | $331.13 | $371.54 | $416.87 |
Pacific Source Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $426.58 | Facility | None | $245.47 | $251.19 | $426.58 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $407.38 | Professional | None | $79.43 | $177.83 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $1,584.89 | Facility | None | $331.13 | $660.69 | $1,584.89 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | None | $426.58 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $724.44 | Facility | None | $549.54 | $549.54 | $724.44 |
United Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $331.13 | Professional | None | $154.88 | $165.96 | $331.13 |
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 $100.00 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $100.00 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $40.74 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $30.20 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $20.42 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $125.89 | $125.89 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.12 |
Where Oregon sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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
$331
WI $407CO $178
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.