How much rates vary
Facilitymedian $138 · 10th to 90th $95 to $708Professionalmedian $135 · 10th to 90th $79 to $209
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 $77.62 Median $102.33 Typical High $102.33 | Professional | None | $77.62 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $660.69 Typical High $776.25 | Facility | None | $537.03 | $660.69 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $194.98 | Professional | None | $97.72 | $128.82 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $158.49 | Professional | None | $114.82 | $131.83 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $165.96 Typical High $194.98 | Facility | None | $102.33 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $186.21 | Professional | None | $102.33 | $104.71 | $186.21 |
Pacific Source Setting Facility Modifier None Typical Low $87.10 Median $138.04 Typical High $144.54 | Facility | None | $87.10 | $138.04 | $144.54 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $446.68 Typical High $11,481.54 | Facility | None | $100.00 | $446.68 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $208.93 | Professional | None | $79.43 | $134.90 | $208.93 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,737.80 | Facility | None | $1,148.15 | $1,548.82 | $1,737.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $208.93 | Professional | None | $134.90 | $141.25 | $208.93 |
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 $107.15 Median $151.36 Typical High $245.47 | Professional | None | $107.15 | $151.36 | $245.47 |
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 $38.90 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $38.90 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $15.49 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $11.75 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.76 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.23 |
Where Oregon sits
The same service costs 4.5 times more in Wisconsin than in Kentucky. 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· 10th of 51
$138
WI $288KY $64.57
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.