How much rates vary
Facilitymedian $71 · 10th to 90th $55 to $76Professionalmedian $55 · 10th to 90th $31 to $81
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 $40.74 Median $43.65 Typical High $43.65 | Professional | None | $40.74 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $154.88 Typical High $194.98 | Professional | None | $60.26 | $154.88 | $194.98 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $63.10 Typical High $74.13 | Facility | None | $43.65 | $63.10 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $74.13 | Professional | None | $43.65 | $67.61 | $74.13 |
Pacific Source Setting Facility Modifier None Typical Low $57.54 Median $70.79 Typical High $75.86 | Facility | None | $57.54 | $70.79 | $75.86 |
Pacific Source Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | None | $72.44 | $72.44 | $75.86 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $74.13 | Facility | None | $41.69 | $45.71 | $74.13 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $64.57 Typical High $79.43 | Professional | None | $30.90 | $64.57 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $281.84 | Facility | None | $58.88 | $117.49 | $281.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | None | $75.86 | $81.28 | $81.28 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Facility | None | $109.65 | $109.65 | $144.54 |
United Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $66.07 | Professional | None | $30.20 | $33.11 | $66.07 |
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 $19.95 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $19.95 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.13 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.07 | $4.37 | $4.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
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
$63.10
MT $79.43DE $30.90
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.