How much rates vary
Facilitymedian $102 · 10th to 90th $71 to $138Professionalmedian $66 · 10th to 90th $45 to $117
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 $60.26 Median $63.10 Typical High $66.07 | Professional | None | $60.26 | $63.10 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $281.84 | Professional | None | $81.28 | $223.87 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $91.20 Typical High $117.49 | Facility | None | $63.10 | $91.20 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $112.20 | Professional | None | $63.10 | $97.72 | $112.20 |
Pacific Source Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $104.71 | Facility | None | $93.33 | $102.33 | $104.71 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $109.65 | Facility | None | $61.66 | $66.07 | $109.65 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $102.33 | Professional | None | $44.67 | $79.43 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $85.11 Median $165.96 Typical High $407.38 | Facility | None | $85.11 | $165.96 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | None | $109.65 | $117.49 | $117.49 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Facility | None | $154.88 | $154.88 | $208.93 |
United Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $93.33 | Professional | None | $44.67 | $47.86 | $93.33 |
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 $30.20 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $8.91 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $8.91 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.31 |
Where Oregon sits
The same service costs 2.1 times more in Wisconsin 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
$85.11
WI $100NJ $47.86
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.