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 $724.44 Median $977.24 Typical High $977.24 | Professional | None | $724.44 | $977.24 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,089.30 | Professional | None | $831.76 | $1,230.27 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,737.80 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,412.54 Typical High $1,659.59 | Facility | None | $977.24 | $1,412.54 | $1,659.59 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,778.28 | Professional | None | $954.99 | $1,023.29 | $1,778.28 |
Pacific Source Setting Facility Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,513.56 | Facility | None | $851.14 | $1,258.93 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $1,380.38 Typical High $1,659.59 | Facility | None | $912.01 | $1,380.38 | $1,659.59 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,230.27 Typical High $2,238.72 | Professional | None | $79.43 | $1,230.27 | $2,238.72 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,513.56 | $1,949.84 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,187.76 | Professional | None | $954.99 | $1,174.90 | $2,187.76 |
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 $380.19 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $114.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $97.72 | $97.72 |
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· 8th of 51
$1,230
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.