How much rates vary
Facilitymedian $112 · 10th to 90th $87 to $126Professionalmedian $79 · 10th to 90th $55 to $129
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 $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $263.03 Typical High $338.84 | Professional | None | $89.13 | $263.03 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $87.10 Typical High $117.49 | Facility | None | $69.18 | $87.10 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $107.15 Typical High $117.49 | Professional | None | $69.18 | $107.15 | $117.49 |
Pacific Source Setting Facility Modifier None Typical Low $91.20 Median $112.20 Typical High $125.89 | Facility | None | $91.20 | $112.20 | $125.89 |
Pacific Source Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | None | $114.82 | $114.82 | $125.89 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $117.49 | Facility | None | $70.79 | $75.86 | $117.49 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $112.20 | Professional | None | $54.95 | $79.43 | $112.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $93.33 Median $186.21 Typical High $446.68 | Facility | None | $93.33 | $186.21 | $446.68 |
Regence BlueShield Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | None | $120.23 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $251.19 | Facility | None | $190.55 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $112.20 | Professional | None | $52.48 | $57.54 | $112.20 |
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 $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $34.67 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Where Oregon sits
The same service costs 4.4 times more in Kansas 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· 17th of 51
$91.20
KS $245VT $56.23
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.