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 $125.89 Median $154.88 Typical High $812.83 | Professional | None | $125.89 | $154.88 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $331.13 | Professional | None | $154.88 | $194.98 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $281.84 | Professional | None | $177.83 | $229.09 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $263.03 Typical High $323.59 | Facility | None | $154.88 | $263.03 | $323.59 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $389.05 | Professional | None | $151.36 | $177.83 | $389.05 |
Pacific Source Setting Facility Modifier None Typical Low $141.25 Median $234.42 Typical High $239.88 | Facility | None | $141.25 | $234.42 | $239.88 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $263.03 Typical High $323.59 | Facility | None | $120.23 | $263.03 | $323.59 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $354.81 | Professional | None | $79.43 | $223.87 | $354.81 |
Regence BlueShield Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $316.23 | Professional | None | $223.87 | $239.88 | $316.23 |
United Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $363.08 | Professional | None | $181.97 | $223.87 | $363.08 |
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 $63.10 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $25.70 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $19.05 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $66.07 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $26.30 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $19.95 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.18 | $15.49 | $15.49 |
Where Oregon sits
The same service costs 3.2 times more in Alaska 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· 7th of 51
$219
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.