How much rates vary
Facilitymedian $120 · 10th to 90th $93 to $138Professionalmedian $79 · 10th to 90th $51 to $138
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 $67.61 Median $74.13 Typical High $74.13 | Professional | None | $67.61 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $263.03 Typical High $331.13 | Professional | None | $102.33 | $263.03 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $125.89 | Facility | None | $74.13 | $107.15 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $125.89 | Professional | None | $74.13 | $114.82 | $125.89 |
Pacific Source Setting Facility Modifier None Typical Low $97.72 Median $120.23 Typical High $128.82 | Facility | None | $97.72 | $120.23 | $128.82 |
Pacific Source Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $131.83 | Professional | None | $112.20 | $123.03 | $131.83 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $77.62 Typical High $125.89 | Facility | None | $70.79 | $77.62 | $125.89 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $120.23 | Professional | None | $51.29 | $79.43 | $120.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $478.63 | Facility | None | $100.00 | $194.98 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | None | $128.82 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $245.47 | Facility | None | $186.21 | $186.21 | $245.47 |
United Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $112.20 | Professional | None | $51.29 | $56.23 | $112.20 |
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 $33.88 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $33.88 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.80 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $7.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $36.31 | $37.15 | $37.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.96 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Where Oregon sits
The same service costs 2.6 times more in Hawaii 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· 16th of 51
$97.72
HI $132DE $51.29
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.