How much rates vary
Facilitymedian $158 · 10th to 90th $95 to $275Professionalmedian $115 · 10th to 90th $63 to $200
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 $60.26 Median $61.66 Typical High $120.23 | Professional | None | $60.26 | $61.66 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $141.25 Typical High $194.98 | Facility | None | $95.50 | $141.25 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $213.80 | Professional | None | $63.10 | $114.82 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $245.47 | Professional | None | $79.43 | $109.65 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $120.23 Typical High $204.17 | Facility | None | $69.18 | $120.23 | $204.17 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $177.83 | Professional | None | $60.26 | $112.20 | $177.83 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $158.49 Typical High $177.83 | Facility | None | $95.50 | $158.49 | $177.83 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $141.25 Typical High $213.80 | Facility | None | $79.43 | $141.25 | $213.80 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $213.80 | Professional | None | $70.79 | $109.65 | $213.80 |
Regence BlueShield Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $630.96 | Facility | None | $398.11 | $549.54 | $630.96 |
Regence BlueShield Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $177.83 | Professional | None | $83.18 | $138.04 | $177.83 |
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 $66.07 Median $120.23 Typical High $223.87 | Professional | None | $66.07 | $120.23 | $223.87 |
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 $30.20 Median $30.90 Typical High $60.26 | Professional | 52 · Reduced service | $30.20 | $30.90 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $23.99 | Professional | 53 · Discontinued | $12.02 | $12.30 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $18.20 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 52 · Reduced service | $30.20 | $30.20 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $23.99 | Professional | 53 · Discontinued | $12.02 | $12.02 | $23.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $18.20 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $12.02 |
Where Oregon sits
The same service costs 3.9 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· 6th of 51
$120
AK $204VA $52.48
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.