How much rates vary
Facilitymedian $68 · 10th to 90th $43 to $245Professionalmedian $52 · 10th to 90th $26 to $85
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 $26.30 Median $38.90 Typical High $52.48 | Professional | None | $26.30 | $38.90 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $95.50 Typical High $831.76 | Facility | None | $51.29 | $95.50 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $48.98 Typical High $85.11 | Professional | None | $26.30 | $48.98 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $44.67 Typical High $89.13 | Professional | None | $31.62 | $44.67 | $89.13 |
Moda Health Setting Facility Modifier None Typical Low $37.15 Median $74.13 Typical High $102.33 | Facility | None | $37.15 | $74.13 | $102.33 |
Moda Health Setting Professional Modifier None Typical Low $26.30 Median $52.48 Typical High $81.28 | Professional | None | $26.30 | $52.48 | $81.28 |
Pacific Source Setting Facility Modifier None Typical Low $39.81 Median $67.61 Typical High $81.28 | Facility | None | $39.81 | $67.61 | $81.28 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $75.86 Typical High $134.90 | Facility | None | $32.36 | $75.86 | $134.90 |
Providence Setting Professional Modifier None Typical Low $30.20 Median $57.54 Typical High $91.20 | Professional | None | $30.20 | $57.54 | $91.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $173.78 Median $354.81 Typical High $512.86 | Facility | None | $173.78 | $354.81 | $512.86 |
Regence BlueShield Setting Professional Modifier None Typical Low $34.67 Median $58.88 Typical High $69.18 | Professional | None | $34.67 | $58.88 | $69.18 |
United Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $4,897.79 | Facility | None | $151.36 | $295.12 | $4,897.79 |
United Setting Professional Modifier None Typical Low $28.84 Median $51.29 Typical High $93.33 | Professional | None | $28.84 | $51.29 | $93.33 |
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 $13.18 Median $16.60 Typical High $26.30 | Professional | 52 · Reduced service | $13.18 | $16.60 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.61 Typical High $10.47 | Professional | 53 · Discontinued | $5.25 | $6.61 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $5.01 Typical High $7.76 | Professional | 55 · Aftercare only | $3.89 | $5.01 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.31 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.63 | $3.31 | $5.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $16.22 Typical High $26.30 | Professional | 52 · Reduced service | $13.18 | $16.22 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.46 Typical High $10.47 | Professional | 53 · Discontinued | $5.25 | $6.46 | $10.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.90 Typical High $7.76 | Professional | 55 · Aftercare only | $3.89 | $4.90 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.24 Typical High $5.25 | Professional | 56 · Pre-op care only | $2.63 | $3.24 | $5.25 |
Where Oregon sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 5th of 51
$54.95
AK $91.20VA $23.99
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.