How much rates vary
Facilitymedian $174 · 10th to 90th $95 to $316Professionalmedian $105 · 10th to 90th $100 to $166
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 $104.71 Median $104.71 Typical High $107.15 | Professional | None | $104.71 | $104.71 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $223.87 Typical High $316.23 | Facility | None | $87.10 | $223.87 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | None | $104.71 | $104.71 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $309.03 | Professional | None | $173.78 | $251.19 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $112.20 Typical High $263.03 | Facility | None | $104.71 | $112.20 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $131.83 | Professional | None | $104.71 | $120.23 | $131.83 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $269.15 | Facility | None | $95.50 | $120.23 | $269.15 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $223.87 Typical High $316.23 | Facility | None | $104.71 | $223.87 | $316.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $165.96 | Professional | None | $79.43 | $104.71 | $165.96 |
Regence BlueShield Setting Facility Modifier None Typical Low $173.78 Median $263.03 Typical High $588.84 | Facility | None | $173.78 | $263.03 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | None | $100.00 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $104.71 Median $213.80 Typical High $251.19 | Facility | None | $104.71 | $213.80 | $251.19 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | None | $120.23 | $120.23 | $138.04 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | 53 · Discontinued | $20.89 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where Oregon sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 37th of 51
$105
WY $204VT $105
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.