How much rates vary
Facilitymedian $63 · 10th to 90th $30 to $76Professionalmedian $22 · 10th to 90th $22 to $79
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 $23.99 Median $27.54 Typical High $27.54 | Professional | None | $23.99 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $102.33 | Professional | None | $74.13 | $85.11 | $102.33 |
Moda Health Setting Facility Modifier None Typical Low $17.38 Median $28.84 Typical High $91.20 | Facility | None | $17.38 | $28.84 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Pacific Source Setting Facility Modifier None Typical Low $53.70 Median $63.10 Typical High $69.18 | Facility | None | $53.70 | $63.10 | $69.18 |
Pacific Source Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Providence Setting Facility Modifier None Typical Low $23.44 Median $30.20 Typical High $91.20 | Facility | None | $23.44 | $30.20 | $91.20 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $102.33 | Professional | None | $21.88 | $21.88 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $141.25 | Facility | None | $63.10 | $95.50 | $141.25 |
Regence BlueShield Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $95.50 | Professional | None | $72.44 | $81.28 | $95.50 |
United Setting Professional Modifier None Typical Low $19.95 Median $22.39 Typical High $37.15 | Professional | None | $19.95 | $22.39 | $37.15 |
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 $12.02 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $12.02 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $4.79 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.17 Typical High $4.17 | Professional | 55 · Aftercare only | $3.63 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.40 | $2.75 | $2.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $13.80 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $5.50 | $5.50 | $5.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $4.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $2.75 |
Where Oregon sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 29th of 51
$27.54
KS $135HI $20.89
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.