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 $524.81 Median $660.69 Typical High $660.69 | Professional | None | $524.81 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,412.54 | Professional | None | $575.44 | $851.14 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,412.54 | Professional | None | $912.01 | $1,174.90 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $977.24 Typical High $1,202.26 | Facility | None | $660.69 | $977.24 | $1,202.26 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,202.26 | Professional | None | $660.69 | $707.95 | $1,202.26 |
Pacific Source Setting Facility Modifier None Typical Low $524.81 Median $870.96 Typical High $1,047.13 | Facility | None | $524.81 | $870.96 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $977.24 Typical High $1,202.26 | Facility | None | $616.60 | $977.24 | $1,202.26 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $851.14 Typical High $1,513.56 | Professional | None | $79.43 | $851.14 | $1,513.56 |
Regence BlueShield Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,318.26 | Professional | None | $954.99 | $1,047.13 | $1,318.26 |
United Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,479.11 | Professional | None | $676.08 | $831.76 | $1,479.11 |
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 $263.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $104.71 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $66.07 |
Where Oregon sits
The same service costs 3.2 times more in Alaska than in New York. 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
$871
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.