How much rates vary
Facilitymedian $28 · 10th to 90th $21 to $32Professionalmedian $23 · 10th to 90th $12 to $35
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 $14.79 Median $19.50 Typical High $19.50 | Professional | None | $14.79 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $57.54 Typical High $72.44 | Professional | None | $24.55 | $57.54 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $15.85 Median $23.99 Typical High $32.36 | Facility | None | $15.85 | $23.99 | $32.36 |
Moda Health Setting Professional Modifier None Typical Low $19.50 Median $29.51 Typical High $32.36 | Professional | None | $19.50 | $29.51 | $32.36 |
Pacific Source Setting Facility Modifier None Typical Low $25.12 Median $28.84 Typical High $31.62 | Facility | None | $25.12 | $28.84 | $31.62 |
Pacific Source Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $31.62 | Professional | None | $26.30 | $31.62 | $31.62 |
Providence Setting Facility Modifier None Typical Low $16.22 Median $19.50 Typical High $32.36 | Facility | None | $16.22 | $19.50 | $32.36 |
Providence Setting Professional Modifier None Typical Low $12.02 Median $26.92 Typical High $79.43 | Professional | None | $12.02 | $26.92 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $25.70 Median $50.12 Typical High $123.03 | Facility | None | $25.70 | $50.12 | $123.03 |
Regence BlueShield Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $35.48 | Professional | None | $33.11 | $35.48 | $35.48 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $53.70 | Facility | None | $40.74 | $40.74 | $53.70 |
United Setting Professional Modifier None Typical Low $11.48 Median $12.30 Typical High $24.55 | Professional | None | $11.48 | $12.30 | $24.55 |
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 $7.41 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $7.41 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.02 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.24 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.48 | $1.95 | $1.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $9.55 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $3.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $2.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $1.95 |
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· 8th of 51
$25.70
HI $36.31DE $12.02
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.