How much rates vary
Facilitymedian $44 · 10th to 90th $34 to $50Professionalmedian $34 · 10th to 90th $20 to $50
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 $24.55 Median $26.92 Typical High $26.92 | Professional | None | $24.55 | $26.92 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $36.31 Median $95.50 Typical High $120.23 | Professional | None | $36.31 | $95.50 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $26.92 Median $38.90 Typical High $45.71 | Facility | None | $26.92 | $38.90 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $41.69 Typical High $45.71 | Professional | None | $26.92 | $41.69 | $45.71 |
Pacific Source Setting Facility Modifier None Typical Low $35.48 Median $43.65 Typical High $46.77 | Facility | None | $35.48 | $43.65 | $46.77 |
Pacific Source Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | None | $44.67 | $44.67 | $46.77 |
Providence Setting Facility Modifier None Typical Low $26.92 Median $28.18 Typical High $45.71 | Facility | None | $26.92 | $28.18 | $45.71 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $38.02 Typical High $79.43 | Professional | None | $19.95 | $38.02 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $36.31 Median $70.79 Typical High $173.78 | Facility | None | $36.31 | $70.79 | $173.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $50.12 | Professional | None | $46.77 | $50.12 | $50.12 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $89.13 | Facility | None | $67.61 | $67.61 | $89.13 |
United Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $39.81 | Professional | None | $18.62 | $20.42 | $39.81 |
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 $12.30 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $12.30 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $4.90 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.72 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.45 | $2.69 | $2.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $13.18 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $5.25 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.98 | $4.07 | $4.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.63 | $2.69 | $2.69 |
Where Oregon sits
The same service costs 2.5 times more in Montana 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· 12th of 51
$38.90
MT $48.98DE $19.95
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.