How much rates vary
Facilitymedian $93 · 10th to 90th $72 to $100Professionalmedian $71 · 10th to 90th $44 to $107
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 $52.48 Median $57.54 Typical High $57.54 | Professional | None | $52.48 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $63.10 | Professional | None | $48.98 | $48.98 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $204.17 Typical High $257.04 | Professional | None | $77.62 | $204.17 | $257.04 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $81.28 Typical High $97.72 | Facility | None | $57.54 | $81.28 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $97.72 | Professional | None | $57.54 | $89.13 | $97.72 |
Pacific Source Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $100.00 | Facility | None | $75.86 | $93.33 | $100.00 |
Pacific Source Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $66.07 Typical High $97.72 | Facility | None | $58.88 | $66.07 | $97.72 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $93.33 | Professional | None | $48.98 | $79.43 | $93.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $77.62 Median $151.36 Typical High $371.54 | Facility | None | $77.62 | $151.36 | $371.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | None | $97.72 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $190.55 | Facility | None | $144.54 | $144.54 | $190.55 |
United Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $85.11 | Professional | None | $39.81 | $43.65 | $85.11 |
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 $26.30 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $26.30 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $10.47 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $7.94 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.25 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.18 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.22 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $5.75 |
Where Oregon sits
The same service costs 2.0 times more in Montana than in Vermont. 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· 14th of 51
$79.43
MT $100VT $48.98
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.