How much rates vary
Facilitymedian $25 · 10th to 90th $16 to $69Professionalmedian $19 · 10th to 90th $11 to $39
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 $64.57 Median $5,128.61 Typical High $7,943.28 | Facility | None | $64.57 | $5,128.61 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $16.60 Typical High $16.60 | Professional | None | $11.22 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $26.30 Typical High $30.20 | Professional | None | $21.38 | $26.30 | $30.20 |
Moda Health Setting Facility Modifier None Typical Low $22.91 Median $32.36 Typical High $7,943.28 | Facility | None | $22.91 | $32.36 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $11.48 Median $16.60 Typical High $34.67 | Professional | None | $11.48 | $16.60 | $34.67 |
Pacific Source Setting Facility Modifier None Typical Low $15.14 Median $25.12 Typical High $26.92 | Facility | None | $15.14 | $25.12 | $26.92 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $32.36 Typical High $57.54 | Facility | None | $20.42 | $32.36 | $57.54 |
Providence Setting Professional Modifier None Typical Low $10.72 Median $26.30 Typical High $70.79 | Professional | None | $10.72 | $26.30 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $37.15 | Professional | None | $21.38 | $22.91 | $37.15 |
United Setting Professional Modifier None Typical Low $13.80 Median $24.55 Typical High $42.66 | Professional | None | $13.80 | $24.55 | $42.66 |
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 $5.75 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $5.75 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $2.29 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $12.59 Typical High $12.59 | Professional | 54 · Surgery only | $8.71 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $1.74 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.15 | $1.66 | $1.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $5.62 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $2.24 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $12.59 Typical High $12.59 | Professional | 54 · Surgery only | $8.32 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $1.70 | $2.51 | $2.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.12 | $1.66 | $1.66 |
Where Oregon sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 7th of 51
$21.88
AK $37.15DE $11.22
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.