How much rates vary
Facilitymedian $87 · 10th to 90th $71 to $105Professionalmedian $69 · 10th to 90th $34 to $107
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 $43.65 Median $57.54 Typical High $57.54 | Professional | None | $43.65 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $165.96 Typical High $208.93 | Professional | None | $74.13 | $165.96 | $208.93 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $72.44 Typical High $107.15 | Facility | None | $43.65 | $72.44 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $97.72 | Professional | None | $57.54 | $89.13 | $97.72 |
Pacific Source Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $95.50 | Facility | None | $75.86 | $93.33 | $95.50 |
Pacific Source Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $60.26 Typical High $97.72 | Facility | None | $46.77 | $60.26 | $97.72 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $79.43 Typical High $93.33 | Professional | None | $33.88 | $79.43 | $93.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $77.62 Median $151.36 Typical High $371.54 | Facility | None | $77.62 | $151.36 | $371.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | None | $100.00 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Facility | None | $117.49 | $117.49 | $158.49 |
United Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $70.79 | Professional | None | $32.36 | $36.31 | $70.79 |
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 $21.88 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $21.88 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $8.71 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $6.46 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.37 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $21.88 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $8.71 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $6.46 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.37 | $5.75 | $5.75 |
Where Oregon sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 9th of 51
$75.86
KS $97.72DE $33.88
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.