How much rates vary
Facilitymedian $76 · 10th to 90th $59 to $105Professionalmedian $59 · 10th to 90th $35 to $87
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 $47.86 Typical High $47.86 | Professional | None | $46.77 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $177.83 Typical High $229.09 | Professional | None | $60.26 | $177.83 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $67.61 Typical High $79.43 | Facility | None | $47.86 | $67.61 | $79.43 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $79.43 | Professional | None | $47.86 | $72.44 | $79.43 |
Pacific Source Setting Facility Modifier None Typical Low $61.66 Median $75.86 Typical High $102.33 | Facility | None | $61.66 | $75.86 | $102.33 |
Pacific Source Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $48.98 Typical High $79.43 | Facility | None | $46.77 | $48.98 | $79.43 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $66.07 Typical High $79.43 | Professional | None | $35.48 | $66.07 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $63.10 Median $123.03 Typical High $302.00 | Facility | None | $63.10 | $123.03 | $302.00 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | None | $81.28 | $87.10 | $87.10 |
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 $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $23.44 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.33 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.68 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.55 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
Where Oregon sits
The same service costs 2.8 times more in Montana 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· 13th of 51
$67.61
MT $107NJ $38.90
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.