How much rates vary
Facilitymedian $59 · 10th to 90th $45 to $62Professionalmedian $44 · 10th to 90th $25 to $68
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 $33.11 Median $36.31 Typical High $36.31 | Professional | None | $33.11 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $32.36 | Professional | None | $25.12 | $25.12 | $32.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $125.89 Typical High $158.49 | Professional | None | $48.98 | $125.89 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $51.29 Typical High $61.66 | Facility | None | $36.31 | $51.29 | $61.66 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $61.66 | Professional | None | $36.31 | $47.86 | $61.66 |
Pacific Source Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $61.66 | Facility | None | $47.86 | $58.88 | $61.66 |
Pacific Source Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Providence Setting Facility Modifier None Typical Low $33.88 Median $37.15 Typical High $61.66 | Facility | None | $33.88 | $37.15 | $61.66 |
Providence Setting Professional Modifier None Typical Low $25.12 Median $50.12 Typical High $79.43 | Professional | None | $25.12 | $50.12 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $47.86 Median $95.50 Typical High $234.42 | Facility | None | $47.86 | $95.50 | $234.42 |
Regence BlueShield Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | None | $61.66 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $120.23 | Facility | None | $89.13 | $89.13 | $120.23 |
United Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $53.70 | Professional | None | $24.55 | $27.54 | $53.70 |
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 $16.60 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $16.60 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $6.61 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.90 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.31 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $17.78 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.08 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.25 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.55 | $3.63 | $3.63 |
Where Oregon sits
The same service costs 2.8 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
$50.12
MT $64.57KS $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.