How much rates vary
Facilitymedian $112 · 10th to 90th $87 to $145Professionalmedian $79 · 10th to 90th $51 to $126
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 $61.66 Median $67.61 Typical High $67.61 | Professional | None | $61.66 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $87.10 | Professional | None | $77.62 | $77.62 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $234.42 Typical High $295.12 | Professional | None | $85.11 | $234.42 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $97.72 Typical High $112.20 | Facility | None | $67.61 | $97.72 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $112.20 | Professional | None | $67.61 | $102.33 | $112.20 |
Pacific Source Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $114.82 | Facility | None | $109.65 | $112.20 | $114.82 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $91.20 Typical High $112.20 | Facility | None | $67.61 | $91.20 | $112.20 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $109.65 | Professional | None | $77.62 | $79.43 | $109.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $426.58 | Facility | None | $89.13 | $177.83 | $426.58 |
Regence BlueShield Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $218.78 | Facility | None | $165.96 | $165.96 | $218.78 |
United Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $100.00 | Professional | None | $46.77 | $51.29 | $100.00 |
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 $30.20 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $30.20 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.30 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.17 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where Oregon sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 13th of 51
$93.33
MT $120VA $61.66
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.