How much rates vary
Facilitymedian $23 · 10th to 90th $18 to $26Professionalmedian $18 · 10th to 90th $12 to $27
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 $14.13 Median $14.79 Typical High $14.79 | Professional | None | $14.13 | $14.79 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $52.48 Typical High $67.61 | Professional | None | $18.62 | $52.48 | $67.61 |
Moda Health Setting Facility Modifier None Typical Low $14.79 Median $18.20 Typical High $24.55 | Facility | None | $14.79 | $18.20 | $24.55 |
Moda Health Setting Professional Modifier None Typical Low $14.79 Median $21.88 Typical High $24.55 | Professional | None | $14.79 | $21.88 | $24.55 |
Pacific Source Setting Facility Modifier None Typical Low $19.05 Median $23.44 Typical High $23.99 | Facility | None | $19.05 | $23.44 | $23.99 |
Pacific Source Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $26.30 | Professional | None | $23.99 | $23.99 | $26.30 |
Providence Setting Facility Modifier None Typical Low $14.79 Median $16.22 Typical High $24.55 | Facility | None | $14.79 | $16.22 | $24.55 |
Providence Setting Professional Modifier None Typical Low $12.02 Median $20.89 Typical High $79.43 | Professional | None | $12.02 | $20.89 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $19.50 Median $38.02 Typical High $93.33 | Facility | None | $19.50 | $38.02 | $93.33 |
Regence BlueShield Setting Professional Modifier None Typical Low $25.12 Median $26.92 Typical High $26.92 | Professional | None | $25.12 | $26.92 | $26.92 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Facility | None | $38.02 | $38.02 | $51.29 |
United Setting Professional Modifier None Typical Low $10.96 Median $11.75 Typical High $22.91 | Professional | None | $10.96 | $11.75 | $22.91 |
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 $7.08 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.08 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.82 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.09 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.41 | $1.45 | $1.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.95 | $2.95 | $2.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
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· 18th of 51
$19.95
HI $35.48DE $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.