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 $501.19 Median $645.65 Typical High $645.65 | Professional | None | $501.19 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,348.96 | Professional | None | $549.54 | $812.83 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,380.38 | Professional | None | $891.25 | $1,122.02 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $933.25 Typical High $1,148.15 | Facility | None | $645.65 | $933.25 | $1,148.15 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $1,148.15 | Professional | None | $645.65 | $691.83 | $1,148.15 |
Pacific Source Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $1,000.00 | Facility | None | $501.19 | $831.76 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $933.25 Typical High $1,148.15 | Facility | None | $602.56 | $933.25 | $1,148.15 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $812.83 Typical High $1,445.44 | Professional | None | $79.43 | $812.83 | $1,445.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,288.25 | Professional | None | $912.01 | $1,000.00 | $1,288.25 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,412.54 | Professional | None | $645.65 | $794.33 | $1,412.54 |
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 $251.19 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $263.03 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $52.48 | $64.57 | $64.57 |
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
$832
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.