How much rates vary
Facilitymedian $45 · 10th to 90th $35 to $50Professionalmedian $37 · 10th to 90th $23 to $55
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 $26.30 Median $30.20 Typical High $30.20 | Professional | None | $26.30 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $102.33 Typical High $128.82 | Professional | None | $38.90 | $102.33 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $37.15 Typical High $50.12 | Facility | None | $30.20 | $37.15 | $50.12 |
Moda Health Setting Professional Modifier None Typical Low $30.20 Median $45.71 Typical High $50.12 | Professional | None | $30.20 | $45.71 | $50.12 |
Pacific Source Setting Facility Modifier None Typical Low $38.90 Median $44.67 Typical High $48.98 | Facility | None | $38.90 | $44.67 | $48.98 |
Pacific Source Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Providence Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $50.12 | Facility | None | $30.20 | $34.67 | $50.12 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $41.69 Typical High $79.43 | Professional | None | $25.70 | $41.69 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $39.81 Median $79.43 Typical High $190.55 | Facility | None | $39.81 | $79.43 | $190.55 |
Regence BlueShield Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | None | $51.29 | $54.95 | $54.95 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Facility | None | $70.79 | $70.79 | $95.50 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $42.66 | Professional | None | $20.42 | $21.88 | $42.66 |
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 $13.18 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $13.18 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.25 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.98 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.63 | $3.02 | $3.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $15.14 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.02 |
Where Oregon sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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
$40.74
HI $77.62DC $24.55
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.