How much rates vary
Facilitymedian $25 · 10th to 90th $20 to $120Professionalmedian $15 · 10th to 90th $8 to $33
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 Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.18 | Professional | None | $9.77 | $9.77 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.30 Median $30.20 Typical High $36.31 | Professional | None | $26.30 | $30.20 | $36.31 |
Moda Health Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $32.36 | Facility | None | $9.55 | $13.49 | $32.36 |
Moda Health Setting Professional Modifier None Typical Low $9.77 Median $12.02 Typical High $28.18 | Professional | None | $9.77 | $12.02 | $28.18 |
Pacific Source Setting Facility Modifier None Typical Low $20.42 Median $24.55 Typical High $120.23 | Facility | None | $20.42 | $24.55 | $120.23 |
Pacific Source Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Providence Setting Facility Modifier None Typical Low $8.32 Median $20.89 Typical High $32.36 | Facility | None | $8.32 | $20.89 | $32.36 |
Providence Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $79.43 | Professional | None | $15.49 | $15.49 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $22.91 Median $33.88 Typical High $50.12 | Facility | None | $22.91 | $33.88 | $50.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.70 Median $28.84 Typical High $33.88 | Professional | None | $25.70 | $28.84 | $33.88 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.94 Typical High $13.18 | Professional | None | $7.24 | $7.94 | $13.18 |
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 $4.27 Median $4.90 Typical High $4.90 | Professional | 52 · Reduced service | $4.27 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.74 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $1.29 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.85 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 52 · Reduced service | $4.90 | $4.90 | $4.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $1.48 | $1.48 | $1.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Oregon sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 12th of 51
$15.49
WY $53.70NC $8.71
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.