How much rates vary
Facilitymedian $51 · 10th to 90th $29 to $62Professionalmedian $21 · 10th to 90th $19 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 $19.95 Median $22.91 Typical High $22.91 | Professional | None | $19.95 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $83.18 | Professional | None | $60.26 | $69.18 | $83.18 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $23.99 Typical High $74.13 | Facility | None | $14.13 | $23.99 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Pacific Source Setting Facility Modifier None Typical Low $46.77 Median $51.29 Typical High $56.23 | Facility | None | $46.77 | $51.29 | $56.23 |
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 $19.05 Median $28.84 Typical High $74.13 | Facility | None | $19.05 | $28.84 | $74.13 |
Providence Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $83.18 | Professional | None | $20.89 | $20.89 | $83.18 |
Regence BlueShield Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $117.49 | Facility | None | $52.48 | $77.62 | $117.49 |
Regence BlueShield Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $79.43 | Professional | None | $58.88 | $66.07 | $79.43 |
United Setting Professional Modifier None Typical Low $16.60 Median $18.62 Typical High $30.20 | Professional | None | $16.60 | $18.62 | $30.20 |
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 $9.77 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $9.77 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $3.98 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $2.95 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.95 | $2.29 | $2.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $11.22 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $4.57 | $4.57 | $4.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $3.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.29 |
Where Oregon sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 30th of 51
$22.91
WY $75.86UT $18.62
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.