How much rates vary
Facilitymedian $74 · 10th to 90th $58 to $79Professionalmedian $58 · 10th to 90th $32 to $85
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 $41.69 Median $45.71 Typical High $45.71 | Professional | None | $41.69 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | None | $31.62 | $31.62 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $162.18 Typical High $204.17 | Professional | None | $61.66 | $162.18 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $66.07 Typical High $77.62 | Facility | None | $45.71 | $66.07 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $70.79 Typical High $77.62 | Professional | None | $45.71 | $70.79 | $77.62 |
Pacific Source Setting Facility Modifier None Typical Low $60.26 Median $74.13 Typical High $79.43 | Facility | None | $60.26 | $74.13 | $79.43 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $47.86 Typical High $77.62 | Facility | None | $43.65 | $47.86 | $77.62 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $66.07 Typical High $79.43 | Professional | None | $31.62 | $66.07 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $61.66 Median $120.23 Typical High $295.12 | Facility | None | $61.66 | $120.23 | $295.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | None | $79.43 | $85.11 | $85.11 |
United Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $151.36 | Facility | None | $114.82 | $114.82 | $151.36 |
United Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $67.61 | Professional | None | $31.62 | $34.67 | $67.61 |
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 $20.89 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $20.89 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $8.32 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.31 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.17 | $4.57 | $4.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $22.39 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.76 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.47 | $4.57 | $4.57 |
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
$66.07
MT $83.18DE $31.62
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.