How much rates vary
Facilitymedian $49 · 10th to 90th $28 to $56Professionalmedian $20 · 10th to 90th $17 to $71
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 $18.62 Median $21.38 Typical High $21.38 | Professional | None | $18.62 | $21.38 | $21.38 |
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 $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $77.62 | Professional | None | $56.23 | $66.07 | $77.62 |
Moda Health Setting Facility Modifier None Typical Low $13.18 Median $22.39 Typical High $69.18 | Facility | None | $13.18 | $22.39 | $69.18 |
Moda Health Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Pacific Source Setting Facility Modifier None Typical Low $41.69 Median $43.65 Typical High $53.70 | Facility | None | $41.69 | $43.65 | $53.70 |
Pacific Source Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Providence Setting Facility Modifier None Typical Low $18.20 Median $27.54 Typical High $69.18 | Facility | None | $18.20 | $27.54 | $69.18 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $79.43 | Professional | None | $19.95 | $19.95 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $48.98 Median $72.44 Typical High $109.65 | Facility | None | $48.98 | $72.44 | $109.65 |
Regence BlueShield Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $74.13 | Professional | None | $56.23 | $61.66 | $74.13 |
United Setting Professional Modifier None Typical Low $15.49 Median $17.38 Typical High $28.84 | Professional | None | $15.49 | $17.38 | $28.84 |
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 $9.33 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $9.33 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $3.72 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $2.82 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.86 | $2.14 | $2.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.72 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.14 |
Where Oregon sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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
$21.38
WY $75.86CO $17.38
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.