How much rates vary
Facilitymedian $219 · 10th to 90th $102 to $263Professionalmedian $78 · 10th to 90th $42 to $245
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 $83.18 Median $95.50 Typical High $95.50 | Professional | None | $83.18 | $95.50 | $95.50 |
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 $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $354.81 | Professional | None | $257.04 | $295.12 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $102.33 Typical High $316.23 | Facility | None | $60.26 | $102.33 | $316.23 |
Moda Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Pacific Source Setting Facility Modifier None Typical Low $194.98 Median $218.78 Typical High $239.88 | Facility | None | $194.98 | $218.78 | $239.88 |
Pacific Source Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $81.28 Typical High $316.23 | Facility | None | $56.23 | $81.28 | $316.23 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $354.81 | Professional | None | $41.69 | $41.69 | $354.81 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $489.78 | Facility | None | $223.87 | $331.13 | $489.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $331.13 | Professional | None | $251.19 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $128.82 | Professional | None | $70.79 | $77.62 | $128.82 |
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 $41.69 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $16.60 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.32 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $47.86 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $9.55 |
Where Oregon sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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· 26th of 51
$95.50
ND $295DE $60.26
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.