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 $69.18 Median $91.20 Typical High $131.83 | Professional | None | $69.18 | $91.20 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $41.69 Typical High $66.07 | Professional | 52 · Reduced service | $36.31 | $41.69 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $16.60 Typical High $26.30 | Professional | 53 · Discontinued | $14.79 | $16.60 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.59 Typical High $19.95 | Professional | 55 · Aftercare only | $10.96 | $12.59 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.32 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.24 | $8.32 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $165.96 | Professional | None | $46.77 | $75.86 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $245.47 | Professional | None | $100.00 | $173.78 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $251.19 | Facility | None | $107.15 | $154.88 | $251.19 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $141.25 | Professional | None | $74.13 | $97.72 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $43.65 Typical High $66.07 | Professional | 52 · Reduced service | $37.15 | $43.65 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $17.38 Typical High $26.30 | Professional | 53 · Discontinued | $14.79 | $17.38 | $26.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $19.95 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.71 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.41 | $8.71 | $13.18 |
Pacific Source Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $199.53 | Facility | None | $112.20 | $181.97 | $199.53 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $154.88 Typical High $251.19 | Facility | None | $61.66 | $154.88 | $251.19 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $107.15 Typical High $194.98 | Professional | None | $46.77 | $107.15 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $407.38 | Facility | None | $173.78 | $251.19 | $407.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $138.04 | Professional | None | $66.07 | $97.72 | $138.04 |
United Setting Professional Modifier None Typical Low $33.11 Median $100.00 Typical High $173.78 | Professional | None | $33.11 | $100.00 | $173.78 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Oregon sits
The same service costs 3.0 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· 10th of 51
$95.50
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.