How much rates vary
Facilitymedian $69 · 10th to 90th $54 to $79Professionalmedian $54 · 10th to 90th $30 to $79
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 $37.15 Median $42.66 Typical High $42.66 | Professional | None | $37.15 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $144.54 Typical High $181.97 | Professional | None | $53.70 | $144.54 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $53.70 Typical High $72.44 | Facility | None | $38.02 | $53.70 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $66.07 Typical High $72.44 | Professional | None | $42.66 | $66.07 | $72.44 |
Pacific Source Setting Facility Modifier None Typical Low $56.23 Median $69.18 Typical High $79.43 | Facility | None | $56.23 | $69.18 | $79.43 |
Pacific Source Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $79.43 | Professional | None | $70.79 | $79.43 | $79.43 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $72.44 | Facility | None | $38.02 | $43.65 | $72.44 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $60.26 Typical High $79.43 | Professional | None | $29.51 | $60.26 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $57.54 Median $112.20 Typical High $275.42 | Facility | None | $57.54 | $112.20 | $275.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | None | $72.44 | $79.43 | $79.43 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $134.90 | Facility | None | $102.33 | $102.33 | $134.90 |
United Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $60.26 | Professional | None | $28.18 | $30.90 | $60.26 |
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 $18.62 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.62 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.72 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.62 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.72 | $4.27 | $4.27 |
Where Oregon sits
The same service costs 2.7 times more in Montana 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· 13th of 51
$60.26
MT $83.18DE $30.90
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.