How much rates vary
Facilitymedian $112 · 10th to 90th $87 to $138Professionalmedian $79 · 10th to 90th $54 to $141
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 $64.57 Median $75.86 Typical High $75.86 | Professional | None | $64.57 | $75.86 | $75.86 |
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 $97.72 Median $251.19 Typical High $316.23 | Professional | None | $97.72 | $251.19 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $128.82 | Facility | None | $75.86 | $95.50 | $128.82 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $128.82 | Professional | None | $75.86 | $117.49 | $128.82 |
Pacific Source Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $125.89 | Facility | None | $100.00 | $114.82 | $125.89 |
Pacific Source Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $128.82 | Facility | None | $75.86 | $79.43 | $128.82 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $123.03 | Professional | None | $54.95 | $79.43 | $123.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $102.33 Median $199.53 Typical High $489.78 | Facility | None | $102.33 | $199.53 | $489.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | None | $131.83 | $141.25 | $141.25 |
United Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $234.42 | Facility | None | $177.83 | $177.83 | $234.42 |
United Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $104.71 | Professional | None | $48.98 | $53.70 | $104.71 |
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 $32.36 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $32.36 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $12.88 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $9.77 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.46 | $7.59 | $7.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $13.49 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $10.00 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.76 | $7.59 | $7.59 |
Where Oregon sits
The same service costs 3.1 times more in Hawaii than in New Jersey. 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· 14th of 51
$100
HI $170NJ $54.95
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.