How much rates vary
Facilitymedian $646 · 10th to 90th $407 to $661Professionalmedian $407 · 10th to 90th $302 to $741
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 Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | None | $363.08 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $1,380.38 Typical High $1,737.80 | Professional | None | $512.86 | $1,380.38 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $575.44 Typical High $676.08 | Facility | None | $407.38 | $575.44 | $676.08 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $676.08 | Professional | None | $407.38 | $616.60 | $676.08 |
Pacific Source Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $660.69 | Facility | None | $645.65 | $645.65 | $660.69 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $407.38 Typical High $660.69 | Facility | None | $371.54 | $407.38 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $645.65 | Professional | None | $79.43 | $316.23 | $645.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $741.31 | Professional | None | $691.83 | $741.31 | $741.31 |
United Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $588.84 | Professional | None | $275.42 | $302.00 | $588.84 |
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 $181.97 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $53.70 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $204.17 | $204.17 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Where Oregon sits
The same service costs 2.6 times more in Montana than in New York. 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
$513
MT $708NY $275
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.