How much rates vary
Facilitymedian $93 · 10th to 90th $59 to $708Professionalmedian $89 · 10th to 90th $68 to $138
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 $51.29 Median $67.61 Typical High $67.61 | Professional | None | $51.29 | $67.61 | $67.61 |
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 $64.57 Median $85.11 Typical High $128.82 | Professional | None | $64.57 | $85.11 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $104.71 | Professional | None | $75.86 | $87.10 | $104.71 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $107.15 Typical High $125.89 | Facility | None | $67.61 | $107.15 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $123.03 | Professional | None | $66.07 | $69.18 | $123.03 |
Pacific Source Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $95.50 | Facility | None | $56.23 | $91.20 | $95.50 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $446.68 Typical High $11,481.54 | Facility | None | $64.57 | $446.68 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $138.04 | Professional | None | $67.61 | $89.13 | $138.04 |
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 $89.13 Median $93.33 Typical High $138.04 | Professional | None | $89.13 | $93.33 | $138.04 |
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 $70.79 Median $100.00 Typical High $162.18 | Professional | None | $70.79 | $100.00 | $162.18 |
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 $25.70 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $25.70 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $10.23 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $7.59 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.13 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where Oregon sits
The same service costs 4.7 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· 12th of 51
$91.20
WI $200KY $42.66
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.