How much rates vary
Facilitymedian $30 · 10th to 90th $21 to $91Professionalmedian $19 · 10th to 90th $19 to $46
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 $18.62 Median $18.62 Typical High $23.44 | Professional | None | $18.62 | $18.62 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $29.51 Typical High $66.07 | Facility | None | $20.89 | $29.51 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $18.62 Typical High $18.62 | Professional | None | $16.22 | $18.62 | $18.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $74.13 | Professional | None | $33.11 | $45.71 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $18.62 Median $19.50 Typical High $95.50 | Facility | None | $18.62 | $19.50 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $23.44 | Professional | None | $18.62 | $20.42 | $23.44 |
Pacific Source Setting Facility Modifier None Typical Low $26.30 Median $30.20 Typical High $53.70 | Facility | None | $26.30 | $30.20 | $53.70 |
Providence Setting Facility Modifier None Typical Low $20.89 Median $35.48 Typical High $74.13 | Facility | None | $20.89 | $35.48 | $74.13 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $29.51 Typical High $79.43 | Professional | None | $18.62 | $29.51 | $79.43 |
Regence BlueShield Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $151.36 | Facility | None | $56.23 | $93.33 | $151.36 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | None | $16.98 | $18.62 | $18.62 |
United Setting Facility Modifier None Typical Low $18.62 Median $38.02 Typical High $44.67 | Facility | None | $18.62 | $38.02 | $44.67 |
United Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $23.44 | Professional | None | $20.42 | $20.42 | $23.44 |
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 $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.82 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
Where Oregon sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 29th of 51
$19.50
HI $33.11OH $18.62
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.