How much rates vary
Facilitymedian $49 · 10th to 90th $20 to $141Professionalmedian $34 · 10th to 90th $28 to $58
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 $33.88 Median $41.69 Typical High $77.62 | Facility | None | $33.88 | $41.69 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $42.66 | Professional | None | $33.88 | $33.88 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $51.29 Typical High $79.43 | Facility | None | $26.30 | $51.29 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | None | $33.88 | $33.88 | $37.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $58.88 Typical High $72.44 | Professional | None | $38.02 | $58.88 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $36.31 Typical High $158.49 | Facility | None | $30.90 | $36.31 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $33.88 Typical High $42.66 | Professional | None | $28.18 | $33.88 | $42.66 |
Pacific Source Setting Facility Modifier None Typical Low $20.42 Median $30.20 Typical High $74.13 | Facility | None | $20.42 | $30.20 | $74.13 |
Providence Setting Facility Modifier None Typical Low $33.88 Median $51.29 Typical High $199.53 | Facility | None | $33.88 | $51.29 | $199.53 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $79.43 | Professional | None | $33.88 | $43.65 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $53.70 Median $87.10 Typical High $199.53 | Facility | None | $53.70 | $87.10 | $199.53 |
Regence BlueShield Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | None | $32.36 | $33.88 | $33.88 |
United Setting Facility Modifier None Typical Low $33.88 Median $69.18 Typical High $81.28 | Facility | None | $33.88 | $69.18 | $81.28 |
United Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $32.36 | Professional | None | $28.18 | $28.18 | $32.36 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Where Oregon sits
The same service costs 5.4 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· 28th of 51
$33.88
WY $162AZ $30.20
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.