How much rates vary
Facilitymedian $83 · 10th to 90th $49 to $182Professionalmedian $63 · 10th to 90th $40 to $110
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 $43.65 Median $69.18 Typical High $131.83 | Facility | None | $43.65 | $69.18 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $51.29 Typical High $69.18 | Professional | None | $31.62 | $51.29 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $117.49 | Professional | None | $37.15 | $61.66 | $117.49 |
HealthNet Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | None | $147.91 | $147.91 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.11 Median $72.44 Typical High $144.54 | Professional | None | $33.11 | $72.44 | $144.54 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $91.20 Typical High $288.40 | Facility | None | $48.98 | $91.20 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $38.02 Median $58.88 Typical High $123.03 | Professional | None | $38.02 | $58.88 | $123.03 |
Pacific Source Setting Facility Modifier None Typical Low $51.29 Median $85.11 Typical High $112.20 | Facility | None | $51.29 | $85.11 | $112.20 |
Providence Setting Facility Modifier None Typical Low $35.48 Median $70.79 Typical High $114.82 | Facility | None | $35.48 | $70.79 | $114.82 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $117.49 | Professional | None | $44.67 | $77.62 | $117.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $100.00 | Professional | None | $58.88 | $91.20 | $100.00 |
United Setting Professional Modifier None Typical Low $40.74 Median $72.44 Typical High $114.82 | Professional | None | $40.74 | $72.44 | $114.82 |
10 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 $21.88 Median $21.88 Typical High $34.67 | Professional | 52 · Reduced service | $21.88 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $10.47 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $6.92 |
Moda Health Setting Facility Modifier 25 · Same-day visit Typical Low $85.11 Median $141.25 Typical High $346.74 | Facility | 25 · Same-day visit | $85.11 | $141.25 | $346.74 |
Moda Health Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $40.74 Median $120.23 Typical High $165.96 | Professional | 24 · Unrelated visit after surgery | $40.74 | $120.23 | $165.96 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $42.66 Median $69.18 Typical High $144.54 | Professional | 25 · Same-day visit | $42.66 | $69.18 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $34.67 | Professional | 52 · Reduced service | $21.88 | $21.88 | $34.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $10.47 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $10.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $6.92 |
Moda Health Setting Professional Modifier 93 · Audio-only telehealth Typical Low $38.90 Median $144.54 Typical High $218.78 | Professional | 93 · Audio-only telehealth | $38.90 | $144.54 | $218.78 |
Where Oregon sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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
$63.10
AK $77.62NJ $32.36
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.