How much rates vary
Facilitymedian $91 · 10th to 90th $65 to $107Professionalmedian $71 · 10th to 90th $38 to $117
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 $47.86 Median $63.10 Typical High $63.10 | Professional | None | $47.86 | $63.10 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $186.21 Typical High $234.42 | Professional | None | $79.43 | $186.21 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $79.43 Typical High $107.15 | Facility | None | $52.48 | $79.43 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $97.72 Typical High $107.15 | Professional | None | $63.10 | $97.72 | $107.15 |
Pacific Source Setting Facility Modifier None Typical Low $77.62 Median $91.20 Typical High $104.71 | Facility | None | $77.62 | $91.20 | $104.71 |
Pacific Source Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | None | $79.43 | $79.43 | $104.71 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $64.57 Typical High $107.15 | Facility | None | $51.29 | $64.57 | $107.15 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $79.43 Typical High $102.33 | Professional | None | $38.02 | $79.43 | $102.33 |
Regence BlueShield Setting Facility Modifier None Typical Low $85.11 Median $165.96 Typical High $407.38 | Facility | None | $85.11 | $165.96 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $173.78 | Facility | None | $131.83 | $131.83 | $173.78 |
United Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $77.62 | Professional | None | $37.15 | $39.81 | $77.62 |
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 $23.99 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $23.99 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $9.55 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $7.24 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $31.62 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.31 |
Where Oregon sits
The same service costs 4.9 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· 7th of 51
$79.43
HI $186DE $38.02
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.