How much rates vary
Facilitymedian $110 · 10th to 90th $87 to $123Professionalmedian $79 · 10th to 90th $47 to $135
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 $61.66 Median $72.44 Typical High $72.44 | Professional | None | $61.66 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $239.88 Typical High $302.00 | Professional | None | $93.33 | $239.88 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $123.03 | Facility | None | $72.44 | $91.20 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $123.03 | Professional | None | $72.44 | $112.20 | $123.03 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $109.65 Typical High $120.23 | Facility | None | $95.50 | $109.65 | $120.23 |
Pacific Source Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | None | $109.65 | $120.23 | $120.23 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $75.86 Typical High $123.03 | Facility | None | $64.57 | $75.86 | $123.03 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $117.49 | Professional | None | $46.77 | $79.43 | $117.49 |
Regence BlueShield Setting Facility Modifier None Typical Low $97.72 Median $194.98 Typical High $467.74 | Facility | None | $97.72 | $194.98 | $467.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | None | $125.89 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $223.87 | Facility | None | $169.82 | $169.82 | $223.87 |
United Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $100.00 | Professional | None | $46.77 | $51.29 | $100.00 |
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 $30.90 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $30.90 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $12.30 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $9.33 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.17 | $7.24 | $7.24 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
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 $7.24 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.24 |
Where Oregon sits
The same service costs 2.8 times more in Wisconsin 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· 15th of 51
$95.50
WI $132DE $46.77
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.