How much rates vary
Facilitymedian $19 · 10th to 90th $15 to $23Professionalmedian $17 · 10th to 90th $10 to $25
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 $11.22 Median $13.49 Typical High $13.49 | Professional | None | $11.22 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $43.65 Typical High $54.95 | Professional | None | $16.98 | $43.65 | $54.95 |
Moda Health Setting Facility Modifier None Typical Low $11.48 Median $16.60 Typical High $22.91 | Facility | None | $11.48 | $16.60 | $22.91 |
Moda Health Setting Professional Modifier None Typical Low $13.49 Median $20.42 Typical High $22.91 | Professional | None | $13.49 | $20.42 | $22.91 |
Pacific Source Setting Facility Modifier None Typical Low $17.78 Median $19.95 Typical High $22.39 | Facility | None | $17.78 | $19.95 | $22.39 |
Pacific Source Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $22.39 | Professional | None | $17.78 | $19.05 | $22.39 |
Providence Setting Facility Modifier None Typical Low $11.48 Median $14.45 Typical High $22.91 | Facility | None | $11.48 | $14.45 | $22.91 |
Providence Setting Professional Modifier None Typical Low $10.47 Median $18.62 Typical High $79.43 | Professional | None | $10.47 | $18.62 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $17.78 Median $35.48 Typical High $87.10 | Facility | None | $17.78 | $35.48 | $87.10 |
Regence BlueShield Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $25.12 | Professional | None | $22.91 | $25.12 | $25.12 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $40.74 | Facility | None | $30.90 | $30.90 | $40.74 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $18.62 | Professional | None | $8.71 | $9.33 | $18.62 |
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 $5.62 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $5.62 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.29 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $1.70 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.12 | $1.35 | $1.35 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $6.76 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.69 | $2.69 | $2.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.35 | $1.35 | $1.35 |
Where Oregon sits
The same service costs 3.0 times more in Hawaii 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· 13th of 51
$18.20
HI $31.62DE $10.47
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.