How much rates vary
Facilitymedian $135 · 10th to 90th $105 to $155Professionalmedian $91 · 10th to 90th $66 to $155
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 $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $316.23 Typical High $407.38 | Professional | None | $107.15 | $316.23 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $104.71 Typical High $141.25 | Facility | None | $83.18 | $104.71 | $141.25 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $141.25 | Professional | None | $83.18 | $128.82 | $141.25 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $134.90 Typical High $151.36 | Facility | None | $109.65 | $134.90 | $151.36 |
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 $83.18 Median $91.20 Typical High $141.25 | Facility | None | $83.18 | $91.20 | $141.25 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $134.90 | Professional | None | $66.07 | $79.43 | $134.90 |
Regence BlueShield Setting Facility Modifier None Typical Low $112.20 Median $223.87 Typical High $537.03 | Facility | None | $112.20 | $223.87 | $537.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | None | $144.54 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $302.00 | Facility | None | $229.09 | $229.09 | $302.00 |
United Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $134.90 | Professional | None | $63.10 | $69.18 | $134.90 |
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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where Oregon sits
The same service costs 2.5 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· 15th of 51
$110
MT $162DE $66.07
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.