How much rates vary
Facilitymedian $87 · 10th to 90th $68 to $100Professionalmedian $68 · 10th to 90th $41 to $100
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 $48.98 Median $53.70 Typical High $53.70 | Professional | None | $48.98 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $54.95 | Professional | None | $41.69 | $41.69 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $190.55 Typical High $239.88 | Professional | None | $72.44 | $190.55 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $77.62 Typical High $91.20 | Facility | None | $53.70 | $77.62 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $91.20 | Professional | None | $53.70 | $83.18 | $91.20 |
Pacific Source Setting Facility Modifier None Typical Low $70.79 Median $87.10 Typical High $93.33 | Facility | None | $70.79 | $87.10 | $93.33 |
Pacific Source Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | None | $70.79 | $70.79 | $81.28 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $57.54 Typical High $91.20 | Facility | None | $54.95 | $57.54 | $91.20 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $87.10 | Professional | None | $41.69 | $74.13 | $87.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $72.44 Median $141.25 Typical High $346.74 | Facility | None | $72.44 | $141.25 | $346.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | None | $93.33 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $177.83 | Facility | None | $134.90 | $134.90 | $177.83 |
United Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $79.43 | Professional | None | $37.15 | $40.74 | $79.43 |
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 $24.55 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $24.55 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $9.77 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.41 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.90 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.30 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.94 | $8.13 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.25 | $5.37 | $5.37 |
Where Oregon sits
The same service costs 2.3 times more in Montana than in Florida. 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
$74.13
MT $97.72FL $41.69
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.