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 $60.26 Median $371.54 Typical High $7,943.28 | Facility | None | $60.26 | $371.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $190.55 Typical High $309.03 | Professional | None | $46.77 | $190.55 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $213.80 Typical High $575.44 | Professional | None | $61.66 | $213.80 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $549.54 | Professional | None | $75.86 | $109.65 | $549.54 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $870.96 Typical High $2,187.76 | Facility | None | $81.28 | $870.96 | $2,187.76 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $138.04 Typical High $436.52 | Professional | None | $47.86 | $138.04 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $416.87 | Facility | None | $218.78 | $371.54 | $416.87 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $316.23 Typical High $501.19 | Facility | None | $75.86 | $316.23 | $501.19 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $575.44 | Professional | None | $70.79 | $125.89 | $575.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $81.28 Median $257.04 Typical High $524.81 | Professional | None | $81.28 | $257.04 | $524.81 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $4,897.79 Typical High $6,165.95 | Facility | None | $1,122.02 | $4,897.79 | $6,165.95 |
United Setting Professional Modifier None Typical Low $56.23 Median $190.55 Typical High $549.54 | Professional | None | $56.23 | $190.55 | $549.54 |
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 $27.54 Median $50.12 Typical High $151.36 | Professional | 52 · Reduced service | $27.54 | $50.12 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $19.95 Typical High $60.26 | Professional | 53 · Discontinued | $11.22 | $19.95 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $28.84 Typical High $45.71 | Professional | 55 · Aftercare only | $8.32 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $10.00 Typical High $30.20 | Professional | 56 · Pre-op care only | $5.62 | $10.00 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $102.33 Typical High $151.36 | Professional | 52 · Reduced service | $28.18 | $102.33 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $16.98 Typical High $60.26 | Professional | 53 · Discontinued | $11.22 | $16.98 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $28.84 Typical High $45.71 | Professional | 55 · Aftercare only | $8.51 | $28.84 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.51 Typical High $30.20 | Professional | 56 · Pre-op care only | $5.62 | $8.51 | $30.20 |
Where Oregon sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 9th of 51
$224
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.