How much rates vary
Facilitymedian $100 · 10th to 90th $78 to $112Professionalmedian $76 · 10th to 90th $47 to $115
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 $56.23 Median $61.66 Typical High $61.66 | Professional | None | $56.23 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $218.78 Typical High $275.42 | Professional | None | $77.62 | $218.78 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $102.33 | Facility | None | $61.66 | $81.28 | $102.33 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $104.71 | Professional | None | $61.66 | $95.50 | $104.71 |
Pacific Source Setting Facility Modifier None Typical Low $81.28 Median $100.00 Typical High $107.15 | Facility | None | $81.28 | $100.00 | $107.15 |
Pacific Source Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $67.61 Typical High $104.71 | Facility | None | $63.10 | $67.61 | $104.71 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $100.00 | Professional | None | $50.12 | $79.43 | $100.00 |
Regence BlueShield Setting Facility Modifier None Typical Low $83.18 Median $162.18 Typical High $398.11 | Facility | None | $83.18 | $162.18 | $398.11 |
Regence BlueShield Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | None | $104.71 | $114.82 | $114.82 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $204.17 | Facility | None | $154.88 | $154.88 | $204.17 |
United Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $91.20 | Professional | None | $42.66 | $46.77 | $91.20 |
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 $28.18 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $28.18 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.22 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.51 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.62 | $6.17 | $6.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $6.17 |
Where Oregon sits
The same service costs 2.1 times more in Montana 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· 14th of 51
$81.28
MT $107FL $50.12
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.