How much rates vary
Facilitymedian $151 · 10th to 90th $115 to $174Professionalmedian $91 · 10th to 90th $65 to $174
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 $91.20 Median $91.20 Typical High $93.33 | Professional | None | $91.20 | $91.20 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $323.59 Typical High $407.38 | Professional | None | $117.49 | $323.59 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $158.49 | Facility | None | $91.20 | $117.49 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $158.49 | Professional | None | $91.20 | $125.89 | $158.49 |
Pacific Source Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $158.49 | Facility | None | $123.03 | $151.36 | $158.49 |
Pacific Source Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $158.49 | Professional | None | $123.03 | $154.88 | $158.49 |
Providence Setting Facility Modifier None Typical Low $89.13 Median $95.50 Typical High $158.49 | Facility | None | $89.13 | $95.50 | $158.49 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $151.36 | Professional | None | $64.57 | $79.43 | $151.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $245.47 Typical High $588.84 | Facility | None | $123.03 | $245.47 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | None | $158.49 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $309.03 | Facility | None | $229.09 | $229.09 | $309.03 |
United Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $138.04 | Professional | None | $63.10 | $70.79 | $138.04 |
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 $42.66 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.98 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.20 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where Oregon sits
The same service costs 2.8 times more in Kansas 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· 16th of 51
$123
KS $178DE $64.57
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.