How much rates vary
Facilitymedian $123 · 10th to 90th $100 to $141Professionalmedian $85 · 10th to 90th $56 to $138
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 $67.61 Median $75.86 Typical High $75.86 | Professional | None | $67.61 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $263.03 Typical High $331.13 | Professional | None | $95.50 | $263.03 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $125.89 | Facility | None | $75.86 | $93.33 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $125.89 | Professional | None | $75.86 | $114.82 | $125.89 |
Pacific Source Setting Facility Modifier None Typical Low $120.23 Median $123.03 Typical High $128.82 | Facility | None | $120.23 | $123.03 | $128.82 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $125.89 | Facility | None | $75.86 | $100.00 | $125.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $120.23 | Professional | None | $79.43 | $85.11 | $120.23 |
Regence BlueShield Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $478.63 | Facility | None | $100.00 | $194.98 | $478.63 |
Regence BlueShield Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | None | $128.82 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $245.47 | Facility | None | $186.21 | $186.21 | $245.47 |
United Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $109.65 | Professional | None | $52.48 | $56.23 | $109.65 |
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 $33.88 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $13.49 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.76 | $7.59 | $7.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Oregon sits
The same service costs 2.4 times more in Indiana than in Kentucky. 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
$102
IN $162KY $67.61
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.