How much rates vary
Facilitymedian $87 · 10th to 90th $65 to $100Professionalmedian $66 · 10th to 90th $37 to $100
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 $48.98 Median $53.70 Typical High $53.70 | Professional | None | $48.98 | $53.70 | $53.70 |
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 $67.61 Median $186.21 Typical High $234.42 | Professional | None | $67.61 | $186.21 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $67.61 Typical High $91.20 | Facility | None | $53.70 | $67.61 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $91.20 | Professional | None | $53.70 | $81.28 | $91.20 |
Pacific Source Setting Facility Modifier None Typical Low $70.79 Median $87.10 Typical High $91.20 | Facility | None | $70.79 | $87.10 | $91.20 |
Pacific Source Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $53.70 Typical High $91.20 | Facility | None | $50.12 | $53.70 | $91.20 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $72.44 Typical High $87.10 | Professional | None | $37.15 | $72.44 | $87.10 |
Regence BlueShield Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $346.74 | Facility | None | $70.79 | $141.25 | $346.74 |
Regence BlueShield Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | None | $91.20 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $177.83 | Facility | None | $131.83 | $131.83 | $177.83 |
United Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $79.43 | Professional | None | $37.15 | $40.74 | $79.43 |
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 $24.55 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $24.55 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $9.77 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.24 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.90 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where Oregon sits
The same service costs 2.8 times more in Kansas 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· 14th of 51
$72.44
KS $107DE $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.