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 $89.13 Median $89.13 Typical High $104.71 | Professional | None | $89.13 | $89.13 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $165.96 | Professional | None | $67.61 | $91.20 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $199.53 | Professional | None | $112.20 | $151.36 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $169.82 Typical High $213.80 | Facility | None | $104.71 | $169.82 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $144.54 | Professional | None | $69.18 | $100.00 | $144.54 |
Pacific Source Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $162.18 | Facility | None | $95.50 | $154.88 | $162.18 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $169.82 Typical High $204.17 | Facility | None | $91.20 | $169.82 | $204.17 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $194.98 | Professional | None | $70.79 | $97.72 | $194.98 |
Regence BlueShield Setting Facility Modifier None Typical Low $147.91 Median $213.80 Typical High $323.59 | Facility | None | $147.91 | $213.80 | $323.59 |
Regence BlueShield Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $158.49 | Professional | None | $128.82 | $134.90 | $158.49 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $93.33 | Facility | None | $64.57 | $64.57 | $93.33 |
United Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $218.78 | Professional | None | $104.71 | $138.04 | $218.78 |
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 $44.67 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $44.67 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $21.38 | Professional | 53 · Discontinued | $17.78 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $44.67 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $21.38 | Professional | 53 · Discontinued | $17.78 | $17.78 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $10.47 |
Where Oregon sits
The same service costs 8.1 times more in Alaska than in Indiana. 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
$115
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.