How much rates vary
Facilitymedian $81 · 10th to 90th $62 to $95Professionalmedian $71 · 10th to 90th $37 to $105
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 $46.77 Median $56.23 Typical High $56.23 | Professional | None | $46.77 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $181.97 Typical High $223.87 | Professional | None | $70.79 | $181.97 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $70.79 Typical High $95.50 | Facility | None | $46.77 | $70.79 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | None | $56.23 | $87.10 | $95.50 |
Pacific Source Setting Facility Modifier None Typical Low $74.13 Median $83.18 Typical High $93.33 | Facility | None | $74.13 | $83.18 | $93.33 |
Pacific Source Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $57.54 Typical High $95.50 | Facility | None | $46.77 | $57.54 | $95.50 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $77.62 Typical High $91.20 | Professional | None | $37.15 | $77.62 | $91.20 |
Regence BlueShield Setting Facility Modifier None Typical Low $75.86 Median $147.91 Typical High $363.08 | Facility | None | $75.86 | $147.91 | $363.08 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | None | $95.50 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Facility | None | $125.89 | $125.89 | $169.82 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $75.86 | Professional | None | $36.31 | $38.90 | $75.86 |
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 $23.44 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $23.44 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $9.33 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $7.08 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.68 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Where Oregon sits
The same service costs 2.1 times more in Arkansas than in Colorado. 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· 12th of 51
$75.86
AR $85.11CO $39.81
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.