How much rates vary
Facilitymedian $182 · 10th to 90th $102 to $251Professionalmedian $110 · 10th to 90th $83 to $214
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 $104.71 Median $229.09 Typical High $229.09 | Facility | None | $104.71 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | None | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $19.50 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.55 | $10.23 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $269.15 | Professional | None | $169.82 | $208.93 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $177.83 Typical High $251.19 | Facility | None | $102.33 | $177.83 | $251.19 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $208.93 | Professional | None | $102.33 | $102.33 | $208.93 |
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 $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
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 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $173.78 Typical High $194.98 | Facility | None | $112.20 | $173.78 | $194.98 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $147.91 Typical High $251.19 | Facility | None | $102.33 | $147.91 | $251.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $263.03 | Professional | None | $79.43 | $83.18 | $263.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $154.88 Median $234.42 Typical High $398.11 | Facility | None | $154.88 | $234.42 | $398.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $177.83 | Professional | None | $151.36 | $165.96 | $177.83 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $154.88 | Facility | None | $107.15 | $107.15 | $154.88 |
United Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $263.03 | Professional | None | $91.20 | $158.49 | $263.03 |
1 more rate 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 |
|---|---|---|---|---|---|
Moda Health Setting Professional Modifier 93 · Audio-only telehealth Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 93 · Audio-only telehealth | $95.50 | $95.50 | $95.50 |
Where Oregon sits
The same service costs 3.3 times more in Alaska 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
$117
AK $229KY $69.18
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.