How much rates vary
Facilitymedian $162 · 10th to 90th $141 to $288Professionalmedian $100 · 10th to 90th $65 to $288
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 $107.15 Median $138.04 Typical High $138.04 | Professional | None | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $53.70 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $21.38 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $389.05 | Professional | None | $169.82 | $288.40 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $138.04 Typical High $194.98 | Facility | None | $125.89 | $138.04 | $194.98 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $162.18 | Professional | None | $125.89 | $138.04 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $60.26 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $23.99 | $27.54 | $27.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $17.78 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $13.80 |
Pacific Source Setting Facility Modifier None Typical Low $144.54 Median $162.18 Typical High $165.96 | Facility | None | $144.54 | $162.18 | $165.96 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $660.69 | Facility | None | $141.25 | $186.21 | $660.69 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $2,570,395.78 | Professional | None | $64.57 | $91.20 | $2,570,395.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $134.90 Median $263.03 Typical High $645.65 | Facility | None | $134.90 | $263.03 | $645.65 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $288.40 | Facility | None | $218.78 | $218.78 | $288.40 |
United Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $77.62 | Professional | None | $63.10 | $66.07 | $77.62 |
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 2.4 times more in Montana than in Utah. 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
$100
MT $155UT $64.57
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.