How much rates vary
Facilitymedian $47 · 10th to 90th $36 to $52Professionalmedian $36 · 10th to 90th $20 to $54
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 $26.30 Median $28.84 Typical High $28.84 | Professional | None | $26.30 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $102.33 Typical High $128.82 | Professional | None | $38.90 | $102.33 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $38.02 Typical High $47.86 | Facility | None | $28.84 | $38.02 | $47.86 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $44.67 Typical High $48.98 | Professional | None | $28.84 | $44.67 | $48.98 |
Pacific Source Setting Facility Modifier None Typical Low $38.02 Median $46.77 Typical High $48.98 | Facility | None | $38.02 | $46.77 | $48.98 |
Pacific Source Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | None | $47.86 | $47.86 | $52.48 |
Providence Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $48.98 | Facility | None | $27.54 | $29.51 | $48.98 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $40.74 Typical High $79.43 | Professional | None | $19.95 | $40.74 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $38.90 Median $75.86 Typical High $186.21 | Facility | None | $38.90 | $75.86 | $186.21 |
Regence BlueShield Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $53.70 | Professional | None | $48.98 | $53.70 | $53.70 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Facility | None | $70.79 | $70.79 | $95.50 |
United Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $42.66 | Professional | None | $19.95 | $21.88 | $42.66 |
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 $13.18 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $13.18 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.25 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $3.98 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.63 | $2.88 | $2.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.13 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.62 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.82 | $2.88 | $2.88 |
Where Oregon sits
The same service costs 2.6 times more in Montana 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· 13th of 51
$40.74
MT $52.48DE $19.95
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.