How much rates vary
Facilitymedian $54 · 10th to 90th $42 to $60Professionalmedian $41 · 10th to 90th $24 to $62
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 $32.36 Median $33.11 Typical High $33.11 | Professional | None | $32.36 | $33.11 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $117.49 Typical High $147.91 | Professional | None | $44.67 | $117.49 | $147.91 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $47.86 Typical High $56.23 | Facility | None | $33.11 | $47.86 | $56.23 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $56.23 | Professional | None | $33.11 | $43.65 | $56.23 |
Pacific Source Setting Facility Modifier None Typical Low $43.65 Median $53.70 Typical High $57.54 | Facility | None | $43.65 | $53.70 | $57.54 |
Pacific Source Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $34.67 Typical High $56.23 | Facility | None | $33.11 | $34.67 | $56.23 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $46.77 Typical High $79.43 | Professional | None | $23.99 | $46.77 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $44.67 Median $87.10 Typical High $213.80 | Facility | None | $44.67 | $87.10 | $213.80 |
Regence BlueShield Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | None | $57.54 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $109.65 | Facility | None | $83.18 | $83.18 | $109.65 |
United Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $48.98 | Professional | None | $22.91 | $25.12 | $48.98 |
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 $15.14 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $15.14 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.03 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $4.57 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.02 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.22 | $16.60 | $16.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $4.90 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.24 | $3.31 | $3.31 |
Where Oregon sits
The same service costs 2.6 times more in Montana than in Kansas. 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
$45.71
MT $60.26KS $23.44
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.