How much rates vary
Facilitymedian $78 · 10th to 90th $59 to $100Professionalmedian $59 · 10th to 90th $35 to $89
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 $45.71 Median $47.86 Typical High $50.12 | Professional | None | $45.71 | $47.86 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $169.82 Typical High $218.78 | Professional | None | $60.26 | $169.82 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $60.26 Typical High $81.28 | Facility | None | $45.71 | $60.26 | $81.28 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $81.28 | Professional | None | $47.86 | $63.10 | $81.28 |
Pacific Source Setting Facility Modifier None Typical Low $63.10 Median $77.62 Typical High $97.72 | Facility | None | $63.10 | $77.62 | $97.72 |
Pacific Source Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $48.98 Typical High $81.28 | Facility | None | $45.71 | $48.98 | $81.28 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $67.61 Typical High $79.43 | Professional | None | $35.48 | $67.61 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $64.57 Median $125.89 Typical High $309.03 | Facility | None | $64.57 | $125.89 | $309.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | None | $81.28 | $89.13 | $89.13 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $165.96 | Facility | None | $123.03 | $123.03 | $165.96 |
United Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $74.13 | Professional | None | $34.67 | $38.02 | $74.13 |
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 $22.91 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.12 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.76 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.57 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $22.91 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.12 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.76 | $7.08 | $7.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.57 | $4.79 | $4.79 |
Where Oregon sits
The same service costs 4.7 times more in Hawaii 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
$64.57
HI $166DE $35.48
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.