How much rates vary
Facilitymedian $105 · 10th to 90th $71 to $155Professionalmedian $74 · 10th to 90th $71 to $95
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 $70.79 Median $70.79 Typical High $89.13 | Professional | None | $70.79 | $70.79 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $131.83 Typical High $151.36 | Facility | None | $74.13 | $131.83 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | None | $70.79 | $70.79 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $190.55 | Professional | None | $81.28 | $158.49 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $138.04 | Facility | None | $70.79 | $74.13 | $138.04 |
Moda Health Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $87.10 | Professional | None | $70.79 | $74.13 | $87.10 |
Pacific Source Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $154.88 | Facility | None | $75.86 | $102.33 | $154.88 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $151.36 | Facility | None | $79.43 | $93.33 | $151.36 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $95.50 | Professional | None | $70.79 | $79.43 | $95.50 |
Regence BlueShield Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $281.84 | Facility | None | $104.71 | $147.91 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $70.79 | Professional | None | $64.57 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $70.79 Median $144.54 Typical High $169.82 | Facility | None | $70.79 | $144.54 | $169.82 |
United Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $85.11 | Professional | None | $74.13 | $74.13 | $85.11 |
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 $35.48 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.72 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $36.31 | $36.31 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Where Oregon sits
The same service costs 1.5 times more in Wyoming than in Florida. 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· 22nd of 51
$74.13
WY $107FL $70.79
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.