How much rates vary
Facilitymedian $58 · 10th to 90th $44 to $65Professionalmedian $44 · 10th to 90th $25 to $66
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 $32.36 Median $34.67 Typical High $34.67 | Professional | None | $32.36 | $34.67 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | None | $24.55 | $24.55 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $123.03 Typical High $154.88 | Professional | None | $47.86 | $123.03 | $154.88 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $45.71 Typical High $58.88 | Facility | None | $34.67 | $45.71 | $58.88 |
Moda Health Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $58.88 | Professional | None | $34.67 | $53.70 | $58.88 |
Pacific Source Setting Facility Modifier None Typical Low $46.77 Median $57.54 Typical High $60.26 | Facility | None | $46.77 | $57.54 | $60.26 |
Pacific Source Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | None | $58.88 | $58.88 | $60.26 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $36.31 Typical High $58.88 | Facility | None | $33.11 | $36.31 | $58.88 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $48.98 Typical High $79.43 | Professional | None | $24.55 | $48.98 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $46.77 Median $93.33 Typical High $223.87 | Facility | None | $46.77 | $93.33 | $223.87 |
Regence BlueShield Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $114.82 | Facility | None | $87.10 | $87.10 | $114.82 |
United Setting Professional Modifier None Typical Low $23.99 Median $26.92 Typical High $52.48 | Professional | None | $23.99 | $26.92 | $52.48 |
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 $15.85 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $15.85 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.46 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $4.79 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.24 | $3.47 | $3.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 52 · Reduced service | $17.38 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.92 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.13 | $5.25 | $5.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.47 | $3.47 | $3.47 |
Where Oregon sits
The same service costs 2.6 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· 13th of 51
$50.12
MT $63.10DE $24.55
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.