How much rates vary
Facilitymedian $50 · 10th to 90th $38 to $54Professionalmedian $38 · 10th to 90th $23 to $58
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 $28.18 Median $30.20 Typical High $30.20 | Professional | None | $28.18 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | None | $26.30 | $26.30 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $107.15 Typical High $134.90 | Professional | None | $41.69 | $107.15 | $134.90 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $43.65 Typical High $51.29 | Facility | None | $30.20 | $43.65 | $51.29 |
Moda Health Setting Professional Modifier None Typical Low $30.20 Median $46.77 Typical High $51.29 | Professional | None | $30.20 | $46.77 | $51.29 |
Pacific Source Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $52.48 | Facility | None | $40.74 | $50.12 | $52.48 |
Pacific Source Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $36.31 Typical High $51.29 | Facility | None | $31.62 | $36.31 | $51.29 |
Providence Setting Professional Modifier None Typical Low $26.30 Median $42.66 Typical High $79.43 | Professional | None | $26.30 | $42.66 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $40.74 Median $81.28 Typical High $194.98 | Facility | None | $40.74 | $81.28 | $194.98 |
Regence BlueShield Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | None | $52.48 | $57.54 | $57.54 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Facility | None | $75.86 | $75.86 | $102.33 |
United Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $45.71 | Professional | None | $20.89 | $23.44 | $45.71 |
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 $14.13 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $14.13 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.62 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.17 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.82 | $3.02 | $3.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $15.14 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.03 | $6.17 | $6.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $4.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.02 |
Where Oregon sits
The same service costs 2.1 times more in Montana than in Alabama. 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
$42.66
MT $54.95AL $26.30
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.