How much rates vary
Facilitymedian $48 · 10th to 90th $37 to $51Professionalmedian $37 · 10th to 90th $22 to $55
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 $26.92 Median $29.51 Typical High $29.51 | Professional | None | $26.92 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $104.71 Typical High $131.83 | Professional | None | $39.81 | $104.71 | $131.83 |
Moda Health Setting Facility Modifier None Typical Low $29.51 Median $38.90 Typical High $48.98 | Facility | None | $29.51 | $38.90 | $48.98 |
Moda Health Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $50.12 | Professional | None | $29.51 | $45.71 | $50.12 |
Pacific Source Setting Facility Modifier None Typical Low $38.90 Median $47.86 Typical High $51.29 | Facility | None | $38.90 | $47.86 | $51.29 |
Pacific Source Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Providence Setting Facility Modifier None Typical Low $30.20 Median $33.88 Typical High $50.12 | Facility | None | $30.20 | $33.88 | $50.12 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $41.69 Typical High $79.43 | Professional | None | $24.55 | $41.69 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $39.81 Median $77.62 Typical High $190.55 | Facility | None | $39.81 | $77.62 | $190.55 |
Regence BlueShield Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | None | $51.29 | $54.95 | $54.95 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $97.72 | Facility | None | $74.13 | $74.13 | $97.72 |
United Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $43.65 | Professional | None | $20.42 | $22.39 | $43.65 |
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 $13.49 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $13.49 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.37 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.07 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.69 | $2.95 | $2.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.45 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.37 | $4.47 | $4.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
Where Oregon sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$42.66
MT $53.70AZ $24.55
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.