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 $91.20 Median $112.20 Typical High $112.20 | Professional | None | $91.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $239.88 | Professional | None | $112.20 | $141.25 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $204.17 | Professional | None | $141.25 | $162.18 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $190.55 Typical High $234.42 | Facility | None | $112.20 | $190.55 | $234.42 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $194.98 | Professional | None | $112.20 | $128.82 | $194.98 |
Pacific Source Setting Facility Modifier None Typical Low $102.33 Median $169.82 Typical High $177.83 | Facility | None | $102.33 | $169.82 | $177.83 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $234.42 | Facility | None | $87.10 | $190.55 | $234.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $257.04 | Professional | None | $79.43 | $162.18 | $257.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $229.09 | Professional | None | $158.49 | $173.78 | $229.09 |
United Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $263.03 | Professional | None | $131.83 | $162.18 | $263.03 |
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 $45.71 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $45.71 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $18.20 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.12 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $47.86 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $19.05 | $22.39 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $14.13 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.55 | $11.22 | $11.22 |
Where Oregon sits
The same service costs 3.1 times more in Alaska than in Florida. 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· 5th of 51
$162
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.