How much rates vary
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 $11.75 Median $13.80 Typical High $23.99 | Professional | None | $11.75 | $13.80 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $26.30 Typical High $50.12 | Professional | None | $14.13 | $26.30 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $45.71 | Professional | None | $15.14 | $22.39 | $45.71 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $23.99 Typical High $44.67 | Facility | None | $15.14 | $23.99 | $44.67 |
Moda Health Setting Professional Modifier None Typical Low $11.75 Median $23.99 Typical High $44.67 | Professional | None | $11.75 | $23.99 | $44.67 |
Pacific Source Setting Facility Modifier None Typical Low $19.05 Median $31.62 Typical High $35.48 | Facility | None | $19.05 | $31.62 | $35.48 |
Providence Setting Facility Modifier None Typical Low $13.18 Median $30.20 Typical High $46.77 | Facility | None | $13.18 | $30.20 | $46.77 |
Providence Setting Professional Modifier None Typical Low $14.45 Median $26.92 Typical High $70.79 | Professional | None | $14.45 | $26.92 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $16.60 Median $30.20 Typical High $52.48 | Professional | None | $16.60 | $30.20 | $52.48 |
United Setting Professional Modifier None Typical Low $15.49 Median $28.18 Typical High $51.29 | Professional | None | $15.49 | $28.18 | $51.29 |
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 $5.89 Median $6.92 Typical High $12.02 | Professional | 52 · Reduced service | $5.89 | $6.92 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.75 Typical High $4.79 | Professional | 53 · Discontinued | $2.34 | $2.75 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.09 Typical High $3.63 | Professional | 55 · Aftercare only | $1.74 | $2.09 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.38 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.17 | $1.38 | $2.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $5.89 Typical High $12.02 | Professional | 52 · Reduced service | $5.89 | $5.89 | $12.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.34 Typical High $4.79 | Professional | 53 · Discontinued | $2.34 | $2.34 | $4.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $3.63 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $3.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $1.17 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.17 | $1.17 | $2.40 |
Where Oregon sits
The same service costs 3.2 times more in Wisconsin than in Nebraska. 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· 4th of 51
$29.51
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.