How much rates vary
Facilitymedian $27 · 10th to 90th $20 to $31Professionalmedian $21 · 10th to 90th $13 to $31
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 $15.85 Median $16.60 Typical High $16.60 | Professional | None | $15.85 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $60.26 Typical High $77.62 | Professional | None | $20.89 | $60.26 | $77.62 |
Moda Health Setting Facility Modifier None Typical Low $16.60 Median $20.89 Typical High $28.18 | Facility | None | $16.60 | $20.89 | $28.18 |
Moda Health Setting Professional Modifier None Typical Low $16.60 Median $25.70 Typical High $28.18 | Professional | None | $16.60 | $25.70 | $28.18 |
Pacific Source Setting Facility Modifier None Typical Low $21.88 Median $26.92 Typical High $29.51 | Facility | None | $21.88 | $26.92 | $29.51 |
Pacific Source Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Providence Setting Facility Modifier None Typical Low $16.98 Median $18.62 Typical High $28.18 | Facility | None | $16.98 | $18.62 | $28.18 |
Providence Setting Professional Modifier None Typical Low $13.49 Median $23.99 Typical High $79.43 | Professional | None | $13.49 | $23.99 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $22.39 Median $43.65 Typical High $107.15 | Facility | None | $22.39 | $43.65 | $107.15 |
Regence BlueShield Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $30.90 | Professional | None | $28.18 | $30.90 | $30.90 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $57.54 | Facility | None | $43.65 | $43.65 | $57.54 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $25.70 | Professional | None | $12.30 | $13.18 | $25.70 |
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 $7.94 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $7.94 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $3.16 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.40 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.58 | $1.66 | $1.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $8.32 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $3.31 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $2.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.66 | $1.66 | $1.66 |
Where Oregon sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 16th of 51
$23.44
HI $37.15PA $13.49
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.