How much rates vary
Facilitymedian $69 · 10th to 90th $49 to $79Professionalmedian $52 · 10th to 90th $27 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 $39.81 Median $42.66 Typical High $42.66 | Professional | None | $39.81 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $123.03 Typical High $154.88 | Professional | None | $54.95 | $123.03 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $42.66 Median $57.54 Typical High $72.44 | Facility | None | $42.66 | $57.54 | $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 $70.79 | Facility | None | $56.23 | $69.18 | $70.79 |
Pacific Source Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | None | $70.79 | $70.79 | $74.13 |
Providence Setting Facility Modifier None Typical Low $36.31 Median $44.67 Typical High $72.44 | Facility | None | $36.31 | $44.67 | $72.44 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $61.66 Typical High $79.43 | Professional | None | $28.84 | $61.66 | $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 $74.13 Median $79.43 Typical High $79.43 | Professional | None | $74.13 | $79.43 | $79.43 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $117.49 | Facility | None | $87.10 | $87.10 | $117.49 |
United Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $52.48 | Professional | None | $23.99 | $26.92 | $52.48 |
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 $16.22 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $16.22 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $6.46 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $4.79 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.24 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $20.42 | $21.38 | $21.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.13 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.17 | $6.46 | $6.46 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.07 | $4.27 | $4.27 |
Where Oregon sits
The same service costs 4.7 times more in Hawaii than in Florida. 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· 12th of 51
$56.23
HI $132FL $28.18
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.