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 Facility Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $173.78 | Professional | None | $109.65 | $114.82 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $316.23 | Professional | None | $102.33 | $169.82 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $177.83 Typical High $338.84 | Professional | None | $97.72 | $177.83 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $5,011.87 Typical High $7,943.28 | Facility | None | $154.88 | $5,011.87 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $234.42 | Professional | None | $97.72 | $169.82 | $234.42 |
Pacific Source Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $223.87 | Facility | None | $131.83 | $213.80 | $223.87 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $281.84 | Facility | None | $100.00 | $194.98 | $281.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $331.13 | Professional | None | $79.43 | $190.55 | $331.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $338.84 | Professional | None | $131.83 | $208.93 | $338.84 |
United Setting Facility Modifier None Typical Low $5,495.41 Median $10,232.93 Typical High $37,153.52 | Facility | None | $5,495.41 | $10,232.93 | $37,153.52 |
United Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $389.05 | Professional | None | $114.82 | $208.93 | $389.05 |
4 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 $54.95 Median $57.54 Typical High $87.10 | Professional | 52 · Reduced service | $54.95 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $34.67 | Professional | 53 · Discontinued | $21.88 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.38 Typical High $25.70 | Professional | 55 · Aftercare only | $16.22 | $17.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $17.38 |
Where Oregon sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 12th of 51
$204
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.