How much rates vary
Facilitymedian $65 · 10th to 90th $52 to $72Professionalmedian $52 · 10th to 90th $33 to $74
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 $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $151.36 Typical High $194.98 | Professional | None | $53.70 | $151.36 | $194.98 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $56.23 Typical High $67.61 | Facility | None | $39.81 | $56.23 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $67.61 | Professional | None | $39.81 | $61.66 | $67.61 |
Pacific Source Setting Facility Modifier None Typical Low $52.48 Median $64.57 Typical High $69.18 | Facility | None | $52.48 | $64.57 | $69.18 |
Pacific Source Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $72.44 | Professional | None | $60.26 | $66.07 | $72.44 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $56.23 Typical High $67.61 | Facility | None | $41.69 | $56.23 | $67.61 |
Providence Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $79.43 | Professional | None | $40.74 | $57.54 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $53.70 Median $104.71 Typical High $257.04 | Facility | None | $53.70 | $104.71 | $257.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | None | $67.61 | $74.13 | $74.13 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $144.54 | Facility | None | $107.15 | $107.15 | $144.54 |
United Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $64.57 | Professional | None | $30.20 | $33.11 | $64.57 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $3.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.95 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $3.98 |
Where Oregon sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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
$57.54
HI $123KY $39.81
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.