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 $8.32 Median $16.22 Typical High $26.30 | Professional | None | $8.32 | $16.22 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $16.22 Typical High $27.54 | Facility | None | $14.13 | $16.22 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $26.92 Typical High $50.12 | Professional | None | $14.45 | $26.92 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.49 Median $23.44 Typical High $46.77 | Professional | None | $15.49 | $23.44 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $26.92 Typical High $40.74 | Facility | None | $15.14 | $26.92 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $8.71 Median $18.62 Typical High $33.88 | Professional | None | $8.71 | $18.62 | $33.88 |
Pacific Source Setting Facility Modifier None Typical Low $19.95 Median $32.36 Typical High $35.48 | Facility | None | $19.95 | $32.36 | $35.48 |
Providence Setting Facility Modifier None Typical Low $12.88 Median $26.92 Typical High $44.67 | Facility | None | $12.88 | $26.92 | $44.67 |
Providence Setting Professional Modifier None Typical Low $14.79 Median $28.84 Typical High $70.79 | Professional | None | $14.79 | $28.84 | $70.79 |
Regence BlueShield Setting Professional Modifier None Typical Low $17.38 Median $30.90 Typical High $52.48 | Professional | None | $17.38 | $30.90 | $52.48 |
United Setting Professional Modifier None Typical Low $16.60 Median $29.51 Typical High $51.29 | Professional | None | $16.60 | $29.51 | $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 $6.17 Median $6.92 Typical High $12.02 | Professional | 52 · Reduced service | $6.17 | $6.92 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.75 Typical High $4.79 | Professional | 53 · Discontinued | $2.45 | $2.75 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $2.09 Typical High $3.63 | Professional | 55 · Aftercare only | $1.86 | $2.09 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.38 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.23 | $1.38 | $2.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $6.17 Typical High $12.02 | Professional | 52 · Reduced service | $6.17 | $6.17 | $12.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $4.79 | Professional | 53 · Discontinued | $2.45 | $2.45 | $4.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $3.63 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $3.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $2.40 |
Where Oregon sits
The same service costs 3.1 times more in Wisconsin than in Louisiana. 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· 5th of 51
$27.54
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.