How much rates vary
Facilitymedian $60 · 10th to 90th $34 to $141Professionalmedian $33 · 10th to 90th $32 to $65
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 Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $39.81 | Professional | None | $31.62 | $31.62 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $60.26 Typical High $93.33 | Facility | None | $38.02 | $60.26 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | None | $31.62 | $31.62 | $33.11 |
HealthNet Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $114.82 | Professional | None | $58.88 | $79.43 | $114.82 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $51.29 Typical High $223.87 | Facility | None | $31.62 | $51.29 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $31.62 Median $35.48 Typical High $44.67 | Professional | None | $31.62 | $35.48 | $44.67 |
Pacific Source Setting Facility Modifier None Typical Low $39.81 Median $44.67 Typical High $95.50 | Facility | None | $39.81 | $44.67 | $95.50 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $52.48 Typical High $93.33 | Facility | None | $42.66 | $52.48 | $93.33 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $79.43 | Professional | None | $31.62 | $39.81 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $60.26 Median $120.23 Typical High $204.17 | Facility | None | $60.26 | $120.23 | $204.17 |
Regence BlueShield Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $31.62 | Professional | None | $29.51 | $31.62 | $31.62 |
United Setting Facility Modifier None Typical Low $31.62 Median $66.07 Typical High $75.86 | Facility | None | $31.62 | $66.07 | $75.86 |
United Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $40.74 | Professional | None | $35.48 | $35.48 | $40.74 |
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 $15.85 Median $15.85 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $17.78 | $17.78 | $17.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.55 |
Where Oregon sits
The same service costs 1.7 times more in Hawaii 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· 30th of 51
$33.88
HI $54.95KY $31.62
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.