How much rates vary
Facilitymedian $148 · 10th to 90th $141 to $245Professionalmedian $100 · 10th to 90th $72 to $316
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 $117.49 Median $123.03 Typical High $123.03 | Professional | None | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $23.44 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $17.38 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.75 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $436.52 | Professional | None | $151.36 | $316.23 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $173.78 | Facility | None | $112.20 | $144.54 | $173.78 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $144.54 | Professional | None | $112.20 | $123.03 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $60.26 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $23.99 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.30 |
Pacific Source Setting Facility Modifier None Typical Low $144.54 Median $147.91 Typical High $181.97 | Facility | None | $144.54 | $147.91 | $181.97 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $165.96 Typical High $588.84 | Facility | None | $125.89 | $165.96 | $588.84 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $2,570,395.78 | Professional | None | $72.44 | $100.00 | $2,570,395.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $120.23 Median $234.42 Typical High $575.44 | Facility | None | $120.23 | $234.42 | $575.44 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $323.59 | Facility | None | $239.88 | $239.88 | $323.59 |
United Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $89.13 | Professional | None | $69.18 | $74.13 | $89.13 |
3 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Oregon sits
The same service costs 2.6 times more in Montana 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· 36th of 51
$100
MT $186OH $72.44
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.