How much rates vary
Facilitymedian $43 · 10th to 90th $28 to $54Professionalmedian $20 · 10th to 90th $14 to $60
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 $15.14 Median $17.38 Typical High $17.38 | Professional | None | $15.14 | $17.38 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $63.10 | Professional | None | $45.71 | $52.48 | $63.10 |
Moda Health Setting Facility Modifier None Typical Low $10.72 Median $18.20 Typical High $56.23 | Facility | None | $10.72 | $18.20 | $56.23 |
Moda Health Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Pacific Source Setting Facility Modifier None Typical Low $35.48 Median $42.66 Typical High $53.70 | Facility | None | $35.48 | $42.66 | $53.70 |
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 $14.79 Median $28.18 Typical High $56.23 | Facility | None | $14.79 | $28.18 | $56.23 |
Providence Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $79.43 | Professional | None | $20.42 | $20.42 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $39.81 Median $58.88 Typical High $89.13 | Facility | None | $39.81 | $58.88 | $89.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $60.26 | Professional | None | $45.71 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $12.59 Median $14.13 Typical High $23.44 | Professional | None | $12.59 | $14.13 | $23.44 |
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 $7.59 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $7.59 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.02 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.24 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.51 | $1.74 | $1.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $8.71 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
Where Oregon sits
The same service costs 8.7 times more in Hawaii than in Kansas. 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· 35th of 51
$20.42
HI $85.11KS $9.77
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.