How much rates vary
Facilitymedian $151 · 10th to 90th $115 to $204Professionalmedian $100 · 10th to 90th $72 to $174
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 $91.20 Median $93.33 Typical High $93.33 | Professional | None | $91.20 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $346.74 Typical High $446.68 | Professional | None | $117.49 | $346.74 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $117.49 Typical High $154.88 | Facility | None | $93.33 | $117.49 | $154.88 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $154.88 | Professional | None | $93.33 | $141.25 | $154.88 |
Pacific Source Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $204.17 | Facility | None | $123.03 | $151.36 | $204.17 |
Pacific Source Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $154.88 | Professional | None | $123.03 | $123.03 | $154.88 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $100.00 Typical High $154.88 | Facility | None | $93.33 | $100.00 | $154.88 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $151.36 | Professional | None | $72.44 | $79.43 | $151.36 |
Regence BlueShield Setting Facility Modifier None Typical Low $123.03 Median $245.47 Typical High $588.84 | Facility | None | $123.03 | $245.47 | $588.84 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | None | $158.49 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $331.13 | Facility | None | $251.19 | $251.19 | $331.13 |
United Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $151.36 | Professional | None | $70.79 | $75.86 | $151.36 |
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 $45.71 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $45.71 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.62 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $9.33 |
Where Oregon sits
The same service costs 2.9 times more in Montana than in Florida. 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
$123
MT $209FL $72.44
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.