How much rates vary
Facilitymedian $32 · 10th to 90th $21 to $51Professionalmedian $25 · 10th to 90th $17 to $34
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 $24.55 Median $24.55 Typical High $50.12 | Facility | None | $24.55 | $24.55 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $31.62 | Professional | None | $25.12 | $25.12 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $37.15 Typical High $52.48 | Facility | None | $35.48 | $37.15 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $26.92 | Professional | None | $25.12 | $25.12 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.70 Median $38.02 Typical High $54.95 | Professional | None | $25.70 | $38.02 | $54.95 |
Moda Health Setting Facility Modifier None Typical Low $23.99 Median $25.12 Typical High $50.12 | Facility | None | $23.99 | $25.12 | $50.12 |
Moda Health Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $30.90 | Professional | None | $16.60 | $25.12 | $30.90 |
Pacific Source Setting Facility Modifier None Typical Low $21.38 Median $30.90 Typical High $44.67 | Facility | None | $21.38 | $30.90 | $44.67 |
Providence Setting Facility Modifier None Typical Low $25.12 Median $37.15 Typical High $52.48 | Facility | None | $25.12 | $37.15 | $52.48 |
Providence Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $79.43 | Professional | None | $25.12 | $26.30 | $79.43 |
Regence BlueShield Setting Professional Modifier None Typical Low $23.44 Median $25.12 Typical High $25.12 | Professional | None | $23.44 | $25.12 | $25.12 |
United Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $19.05 | Professional | None | $16.60 | $16.60 | $19.05 |
9 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 $12.30 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $8.32 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $3.31 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $2.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.66 | $1.66 | $1.66 |
Moda Health Setting Professional Modifier JZ · No drug discarded Typical Low $24.55 Median $24.55 Typical High $38.02 | Professional | JZ · No drug discarded | $24.55 | $24.55 | $38.02 |
Where Oregon sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 23rd of 51
$25.12
WY $39.81AZ $20.89
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.