How much rates vary
Facilitymedian $40 · 10th to 90th $30 to $43Professionalmedian $30 · 10th to 90th $17 to $46
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 $22.39 Median $23.99 Typical High $23.99 | Professional | None | $22.39 | $23.99 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.11 Median $85.11 Typical High $107.15 | Professional | None | $33.11 | $85.11 | $107.15 |
Moda Health Setting Facility Modifier None Typical Low $23.99 Median $31.62 Typical High $40.74 | Facility | None | $23.99 | $31.62 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $23.99 Median $37.15 Typical High $40.74 | Professional | None | $23.99 | $37.15 | $40.74 |
Pacific Source Setting Facility Modifier None Typical Low $32.36 Median $39.81 Typical High $41.69 | Facility | None | $32.36 | $39.81 | $41.69 |
Pacific Source Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Providence Setting Facility Modifier None Typical Low $22.91 Median $25.12 Typical High $40.74 | Facility | None | $22.91 | $25.12 | $40.74 |
Providence Setting Professional Modifier None Typical Low $16.98 Median $34.67 Typical High $79.43 | Professional | None | $16.98 | $34.67 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $32.36 Median $64.57 Typical High $154.88 | Facility | None | $32.36 | $64.57 | $154.88 |
Regence BlueShield Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | None | $41.69 | $45.71 | $45.71 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Facility | None | $60.26 | $60.26 | $81.28 |
United Setting Professional Modifier None Typical Low $16.60 Median $18.62 Typical High $36.31 | Professional | None | $16.60 | $18.62 | $36.31 |
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 $11.22 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $11.22 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.47 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.31 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.24 | $2.40 | $2.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $12.02 | $12.02 | $12.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.79 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.63 Typical High $3.63 | Professional | 55 · Aftercare only | $3.55 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $2.40 |
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· 14th of 51
$33.88
MT $43.65DE $16.98
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.