How much rates vary
Facilitymedian $26 · 10th to 90th $20 to $28Professionalmedian $20 · 10th to 90th $11 to $30
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 $15.14 Median $16.22 Typical High $16.22 | Professional | None | $15.14 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $57.54 Typical High $72.44 | Professional | None | $20.89 | $57.54 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $16.22 Median $21.38 Typical High $26.92 | Facility | None | $16.22 | $21.38 | $26.92 |
Moda Health Setting Professional Modifier None Typical Low $16.22 Median $25.12 Typical High $27.54 | Professional | None | $16.22 | $25.12 | $27.54 |
Pacific Source Setting Facility Modifier None Typical Low $21.38 Median $26.30 Typical High $28.18 | Facility | None | $21.38 | $26.30 | $28.18 |
Pacific Source Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Providence Setting Facility Modifier None Typical Low $15.85 Median $16.98 Typical High $27.54 | Facility | None | $15.85 | $16.98 | $27.54 |
Providence Setting Professional Modifier None Typical Low $11.48 Median $22.91 Typical High $79.43 | Professional | None | $11.48 | $22.91 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $21.88 Median $43.65 Typical High $104.71 | Facility | None | $21.88 | $43.65 | $104.71 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | None | $28.18 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $54.95 | Facility | None | $41.69 | $41.69 | $54.95 |
United Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $24.55 | Professional | None | $11.48 | $12.59 | $24.55 |
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 $7.59 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $7.59 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.02 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.29 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.51 | $1.62 | $1.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Where Oregon sits
The same service costs 5.5 times more in Kansas 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· 15th of 51
$23.44
KS $63.10DE $11.48
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.