How much rates vary
Facilitymedian $36 · 10th to 90th $28 to $41Professionalmedian $28 · 10th to 90th $17 to $42
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 $20.42 Median $22.39 Typical High $22.39 | Professional | None | $20.42 | $22.39 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.20 Median $79.43 Typical High $100.00 | Professional | None | $30.20 | $79.43 | $100.00 |
Moda Health Setting Facility Modifier None Typical Low $22.39 Median $29.51 Typical High $37.15 | Facility | None | $22.39 | $29.51 | $37.15 |
Moda Health Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $38.02 | Professional | None | $22.39 | $34.67 | $38.02 |
Pacific Source Setting Facility Modifier None Typical Low $29.51 Median $36.31 Typical High $38.90 | Facility | None | $29.51 | $36.31 | $38.90 |
Pacific Source Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | None | $37.15 | $37.15 | $38.90 |
Providence Setting Facility Modifier None Typical Low $22.91 Median $25.70 Typical High $38.02 | Facility | None | $22.91 | $25.70 | $38.02 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $32.36 Typical High $79.43 | Professional | None | $18.62 | $32.36 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $30.20 Median $58.88 Typical High $144.54 | Facility | None | $30.20 | $58.88 | $144.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $38.90 Median $41.69 Typical High $41.69 | Professional | None | $38.90 | $41.69 | $41.69 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $74.13 | Facility | None | $56.23 | $56.23 | $74.13 |
United Setting Professional Modifier None Typical Low $15.49 Median $16.98 Typical High $33.11 | Professional | None | $15.49 | $16.98 | $33.11 |
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 $10.23 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $10.23 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.07 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.09 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.04 | $2.24 | $2.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $10.96 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.47 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.31 | $3.39 | $3.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.19 | $2.24 | $2.24 |
Where Oregon sits
The same service costs 2.2 times more in Montana than in New Jersey. 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
$32.36
MT $40.74NJ $18.62
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.